Global, regional, and national disease burden and economic costs of cervical cancer (1991–2021): a multidimensional data synthesis analysis
Objectives
Cervical cancer remains a significant global health concern, particularly in less developed regions. This study aims to assess the global, regional, and national burden of cervical cancer from 1991 to 2021.
Methods
This study synthesizes data from the Global Burden of Disease (GBD) Study 2021, WHO health expenditure databases, and published cost estimates to comprehensively assess the epidemiological and economic burden of cervical cancer from 1991 to 2021. We analyzed age-standardized rates (ASRs) of prevalence (ASPR), incidence (ASIR), mortality (ASMR), and disability-adjusted life years (ASDR) using GBD 2021 data. Temporal trends were quantified via Joinpoint regression-derived average annual percentage changes (AAPCs). Direct medical costs were estimated by integrating GBD incidence data, WHO per-capita health expenditure growth rates, and published treatment costs (2015), reported in both undiscounted and 3% discounted 2021 USD.
Results
In 2021, globally, there were 3,385,000 prevalent cases, 667,000 incident cases, 297,000 deaths, and 7,440,000 DALYs attributed to cervical cancer. Sub-Saharan Africa bore the highest burden, while 12 countries in North Africa and Middle East reported incidence rates below 4 per 100,000. From 1991 to 2021, AAPCs in ASPR, ASIR, ASMR, and ASDR were 0.08%, −0.52%, −1.22%, and −1.21%, respectively. Despite the 2018 elimination initiative, overall incidence and mortality trends showed minimal change. Age-specific incidence notably decreased in individuals over 70, with slower mortality declines in higher age groups. AAPCs positively correlated with 1991 baseline rates and negatively with 2021 socio-demographic index (SDI). Over the same period, the global cumulative direct medical cost of cervical cancer was estimated at USD 9.26 billion (95% UI: 7.95–10.70) without discounting, and USD 7.21 billion (95% UI: 6.14–8.40) when discounted to 2021.
Conclusion
The global cervical cancer prevalence continues to rise, with no country achieving the elimination threshold. High incidence is concentrating in younger ages, while high mortality is shifting to older ages. Sub-Saharan Africa requires targeted interventions to address its disproportionate burden. The substantial economic burden reinforces the urgency for early prevention, equitable treatment access, and sustained health investment.