1990—2021年中国宫颈癌疾病负担趋势分析及2022—2035年预测研究

BackgroundCervical cancer is the fourth most common cancer in women worldwidecausing a huge burden of disease in countries around the worldand is currently an important public health problem facing the worldespecially in developing countries. ObjectiveTo examine the trends in cervical cancer burden in China from 1990 to 2021 and to project the burden from 2022 to 2035providing a scientific basis for formulating and adjusting prevention and control strategies. MethodsUtilizing data from the 2021 Global Burden of DiseaseGBD studywe analyzed the temporal trends in cervical cancer incidencemortalityand disability-adjusted life yearsDALYs in China between 1990 and 2021 using the estimated annual percentage changeEAPC. These trends were compared with those in developed countries such as the United Kingdom. Additionallythe Bayesian age-period-cohortBAPC model was used to predict cervical cancer burden in China from 2022 to 2035. ResultsThe age-standardized incidence rateASIR of cervical cancer in China increased from 11.80 per 100 000 in 1990 to 13.37 per 100 000 in 2021EAPC=0.8895%CI=0.70-1.07. The age-standardized mortality rateASMRdecreased from 6.98 per 100 000 in 1990 to 4.64 per 100 000 in 2021EAPC=-1.0595%CI=-1.20 to -0.89and the age-standardized DALYs rate decreased from 228.2 per 100000 in 1990 to 149.8 per 100 000 in 2021EAPC=-1.0795%CI=-1.22 to -0.92. In 2021the standardized mortality rate of cervical cancer in China was 2.11 times that in the United Kingdom1.73 times that in Australiaand 2.45 times that in the United Statesand the standardized DALYs rates were 2.01 times that in the United Kingdom2.38 times that in Australiaand 1.59 times that in the United Statesrespectively. Between 1990 and 2021the proportion of cervical cancer cases in women aged 35 and older increased from 86.41% to 92.12%while the proportion of DALYs in this group rose from 88.48% to 95.07%. Furthermorethe proportion of deaths in women aged 40 and older increased from 86.42% in 1990 to 95.54% in 2021. A notable upward trend in cervical cancer incidence was observed in women aged 25-54with the most pronounced increase in the 45-49 age groupEAPC=1.4995%CI=1.2-1.78. Among women under 60the 45-49 age group showed the smallest decline in mortality and DALYs rates. By 2035the projected age-standardized incidencemortalityand DALYs rates for cervical cancer in China are expected to decrease to 11.83.4and 112.8 per 100 000respectively. ConclusionThe burden of cervical cancer in China remains substantialsurpassing that of developed countries such as the United Kingdom. Women aged 35 and older bear the highest burdenmaking them a key target for prevention and control efforts. It is recommended to gradually promote the national popularization of HPV vaccination for girls aged 9-14 years on the basis of existing experience and explore the feasibility of including it in the national immunization program. At the same time, further improve the coverage rate of cervical cancer screening among 35-44 years oldcombine with strengthening the publicity and education of cervical cancer prevention and control knowledgebuild a comprehensive prevention and control system covering the whole life cycleand reduce the burden of cervical cancer in China.