Population aging drives up the global burden of high-incidence cancers in women, with markedly divergent prevention and control effectiveness across regions with different sociodemographic index: a trend analysis from 1990 to 2021 and projection to 2036 based on GBD 2021

@article{zhirong2026population,
  title = {{Population aging drives up the global burden of high-incidence cancers in women, with markedly divergent prevention and control effectiveness across regions with different sociodemographic index: a trend analysis from 1990 to 2021 and projection to 2036 based on GBD 2021}},
  author = {He Zhirong and Liu Zhenmi},
  journal = {陆军军医大学学报},
  year = {2026},
  month = oct,
  doi = {10.16016/j.2097-0927.202607083},
  url = {https://doi.org/10.16016/j.2097-0927.202607083},
  note = {CC BY},
}

TY  - JOUR
TI  - Population aging drives up the global burden of high-incidence cancers in women, with markedly divergent prevention and control effectiveness across regions with different sociodemographic index: a trend analysis from 1990 to 2021 and projection to 2036 based on GBD 2021
AU  - He Zhirong
AU  - Liu Zhenmi
PY  - 2026
DA  - 2026/10/30
JO  - 陆军军医大学学报
DO  - 10.16016/j.2097-0927.202607083
UR  - https://doi.org/10.16016/j.2097-0927.202607083
AB  - Objective Common cancers in women worldwide are undergoing a transition in burden patterns, with divergent trends across regions. Therefore, systematically analyzing their evolution trends and predicting future trajectories is a key prerequisite for optimizing health resource allocation. Breast, cervical, ovarian, and uterine cancers pose major health threats to women worldwide. This study aimed to analyze the disease burden of female high-incidence cancers and differences across global, Chinese, and different sociodemographic index (SDI) regions from 1990 to 2021, and to predict future trends, thereby providing evidence for prevention and control strategies. Methods Based on data from the GBD 2021 database (http://ghdx.healthdata.org), and taking into account the primary age ranges of the 4 female high-incidence cancers (breast, cervical, ovarian, and uterine cancers), this study extracted data of women aged 20 to 79 years from global, Chinese, and 5 SDI regions (high, high-middle, middle, low-middle, and low) from 1990 to 2021 for disease burden analysis. The disease burden-related indicators included age-standardized incidence rate, age-standardized mortality rate, age-standardized disability-adjusted life year (DALY) rate, and age-standardized case fatality rate, along with their 95% uncertainty intervals (UI). Estimated annual percentage changes (EAPC) and their 95%CI were calculated by fitting a linear regression model ln(y)=α+βx+ε. An age-period-cohort (APC) model was used to decompose the independent effects of age, period, and birth cohort on the temporal trends of disease incidence or mortality. A Bayesian age-period-cohort (BAPC) model was employed to predict the disease burden of the 4 female common cancers globally and in China over the next 15 years. Results In 2021, the age-standardized incidence rate of breast cancer ranked first both globally [46.40 per 100 000 (95%UI: 43.26 to 49.56 per 100 000)] and in China [37.00 per 100 000 (95%UI: 28.23 to 46.95 per 100 000)], far exceeding those of cervical, uterine, and ovarian cancers. The age-standardized case fatality rate of ovarian cancer was the highest in the world, and that of ovarian cancer ranked first in China. There were significant regional differences in disease burden: the age-standardized incidence rates of breast cancer, ovarian cancer, and uterine cancer were the highest in high SDI regions, while the age-standardized incidence rate of cervical cancer and the age-standardized case fatality rates of ovarian cancer were the highest in low SDI regions. From 1990 to 2021, the age-standardized incidence rates of breast cancer and uterine cancer showed an upward trend globally, while those of cervical cancer and ovarian cancer showed a downward trend; globally and in China, the age-standardized mortality rates, age-standardized DALY rates, and age-standardized fatality rates of the 4 diseases all decreased; in the 5 SDI regions, the age-standardized fatality rates of the 4 diseases all decreased. The APC model showed that the age effect manifested as the age-standardized DALY rates and age-standardized incidence rates of the 4 common cancers in women first increased and then decreased with age, while the age-standardized mortality rate showed a continuous upward trend; the period effect manifested as the burden of most common cancers in women showed an upward trend over time, while the age-standardized DALY rate of cervical cancer showed a downward trend over time; the cohort effect manifested as with the advancement of birth cohorts, the age-standardized incidence rates, age-standardized DALY rates, and age-standardized mortality rates of the 4 common cancers in women globally all showed a gradual downward trend. The BAPC model predicted that by 2036, the age-standardized incidence rates of breast cancer and ovarian cancer globally will continue to rise (reaching 48.59/100 000 and 6.89/100 000, respectively), and the age-standardized DALY rate of breast cancer will rise to 472.25/100 000; in China, the age-standardized incidence rates, age-standardized mortality rates, and age-standardized DALY rates of breast cancer, ovarian cancer, and uterine cancer all showed upward trends. Conclusion From 1990 to 2021, the burden of the 4 female common cancers has generally declined overall but showed marked regional divergence. High-SDI regions are dominated by breast, ovarian, and uterine cancers, whereas the burden of cervical cancer is prominent in low-SDI regions. Aging is the primary driver of the increase in disease burden, and disease risk decreases with the advancement of birth cohorts. It is predicted that the incidence rates of breast cancer and ovarian cancer globally will continue to rise in the future, and the burdens of breast cancer, ovarian cancer, and uterine cancer in China will all increase, requiring the implementation of differentiated prevention and control measures. Countermeasures High SDI regions should focus on lifestyle intervention, vigorously advocating active health behaviors such as balanced diet, healthy weight management, and regular physical exercise; low SDI regions need to prioritize the development of screening guidelines, focus on promoting the inclusion of HPV vaccine in national immunization programs, and accelerate the construction of a primary-level “screen-and-treat” service network; middle SDI countries represented by China should, on the basis of further advancing the action plan for accelerated elimination of cervical cancer and incorporating free screening for “two cancers” into basic public health services, further establish a stratified and classified precision screening system, simultaneously strengthen regional resource coordination and allocation, and promote the coordinated improvement of health service accessibility and equity.
SN  - 2097-0927
ER  -