Ruixia Yuan

The global burden, trends and cross‐country inequalities of female breast and gynaecologic cancers: A population based study

AbstractObjectiveTo analyse the global burden, trends and cross‐country inequalities of female breast and gynaecologic cancers (FeBGCs).DesignPopulation‐Based Study.SettingData sourced from the Global Burden of Disease Study 2019.PopulationIndividuals diagnosed with FeBGCs.MethodsAge‐standardised mortality rates (ASMRs), age‐standardised Disability‐Adjusted Life Years (DALYs) rates (ASDRs) and their 95% uncertainty interval (UI) described the burden. Estimated annual percentage changes (EAPCs) and their confidence interval (CI) of age‐standardised rates (ASRs) illustrated trends. Social inequalities were quantified using the Slope Index of Inequality (SII) and Concentration Index.Main Outcome MeasuresThe main outcome measures were the burden of FeBGCs and the trends in its inequalities over time.ResultsIn 2019, the ASDRs per 100 000 females were as follows: breast cancer: 473.83 (95% UI: 437.30–510.51), cervical cancer: 210.64 (95% UI: 177.67–234.85), ovarian cancer: 124.68 (95% UI: 109.13–138.67) and uterine cancer: 210.64 (95% UI: 177.67–234.85). The trends per year from 1990 to 2019 were expressed as EAPCs of ASDRs and these: for Breast cancer: −0.51 (95% CI: −0.57 to −0.45); Cervical cancer: −0.95 (95% CI: −0.99 to −0.89); Ovarian cancer: −0.08 (95% CI: −0.12 to −0.04); and Uterine cancer: −0.84 (95% CI: −0.93 to −0.75). In the Social Inequalities Analysis (1990–2019) the SII changed from 689.26 to 607.08 for Breast, from −226.66 to −239.92 for cervical, from 222.45 to 228.83 for ovarian and from 74.61 to 103.58 for uterine cancer. The concentration index values ranged from 0.2 to 0.4.ConclusionsThe burden of FeBGCs worldwide showed a downward trend from 1990 to 2019. Countries or regions with higher Socio‐demographic Index (SDI) bear a higher DALYs burden of breast, ovarian and uterine cancers, while those with lower SDI bear a heavier burden of cervical cancer. These inequalities increased over time.

The Global, Regional, and National Burdens of Cervical Cancer Attributable to Smoking From 1990 to 2019: Population-Based Study

Background Cervical cancer is the fourth most common cause of cancer death in women worldwide. Smoking is one of the risk factors for cervical cancer. Understanding the global distribution of the disease burden of cervical cancer attributable to smoking and related changes is of clear significance for the prevention and control of cervical cancer in key populations and for tobacco control. As far as we know, research on the burden of cervical cancer attributable to smoking is lacking. Objective We estimated the disease burden and mortality of cervical cancer attributable to smoking and related trends over time at the global, regional, and national levels. Methods Data were obtained from the Global Burden of Disease study website. Age-standardized rates were used to facilitate comparisons of mortality and disability-adjusted life years (DALYs) at different levels. The estimated annual percentage change (EAPC) was used to assess trends in the age-standardized mortality rate (ASMR) and the age-standardized DALY rate (ASDR). A Pearson correlation analysis was used to evaluate correlations between the sociodemographic index and the age-standardized rates. Results In 2019, there were 30,136.65 (95% uncertainty interval [UI]: 14,945.09-49,639.87) cervical cancer–related deaths and 893,735.25 (95% UI 469,201.51-1,440,050.85) cervical cancer–related DALYs attributable to smoking. From 1990 to 2019, the global burden of cervical cancer attributable to smoking showed a decreasing trend around the world; the EAPCs for ASMR and ASDR were –2.11 (95% CI –2.16 to –2.06) and –2.22 (95% CI –2.26 to –2.18), respectively. In terms of age characteristics, in 2019, an upward trend was observed for age in the mortality of cervical cancer attributable to smoking. Analysis of the trend in DALYs with age revealed an initially increasing and then decreasing trend. From 1990 to 2019, the burden of disease in different age groups showed a downward trend. Among 204 countries, 180 countries showed downward trends, 10 countries showed upward trends, and the burden was stable in 14 countries. The Pearson correlation analysis revealed a significant negative correlation between sociodemographic index and the age-standardized rates of cervical cancer attributable to smoking (ρ=–0.228, P<.001 for ASMR and ρ=–0.223, P<.001 for ASDR). Conclusions An increase over time in the absolute number of cervical cancer deaths and DALYs attributable to smoking and a decrease over time in the ASMR and ASDR for cervical cancer attributable to smoking were observed in the overall population, and differences in these variables were also observed between countries and regions. More attention should be paid to cervical cancer prevention and screening in women who smoke, especially in low- and middle-income countries.