Assessing global trends of cervical cancer: 1990-2021.

Abstract

e17510 Background: Cervical cancer (CC) ranks as the fourth most common malignancy and the fourth leading cause of cancer-related deaths globally, with more than 85% of cases occurring in low- and middle-income countries. This study utilized Global Burden of Disease (GBD) estimates for females aged 25 and older to analyze CC trends from 1990 to 2021. Methods: Data were systematically collected from the GBD-2021 study, covering key metrics such as death rates, Disability-Adjusted Life Years (DALY), Years of Life Lost (YLL), Years Lived with Disability (YLD), incidence and prevalence. The dataset was stratified both globally and across 204 countries, with linear regression used to calculate the average annual percentage changes (AAPC). Results: Between 1990 and 2021, the global mortality rate for CC among individuals aged 25 and above decreased from 16.04 to 12.47 per 100,000, with an AAPC of -0.82 (95% CI: -0.94 to -0.71, p<0.0001). However, significant increases were observed in Lesotho (AAPC: 3.67, 95% CI: 2.85 to 4.51, p<0.0001) and Italy (AAPC: 2.90). Conversely, notable declines were seen in the Maldives (AAPC: -5.19) and Kuwait (AAPC: -4.28). Globally, the DALY rate decreased with an AAPC of -0.97 (95% CI: -1.0 to -0.88, p<0.0001). Significant increases in DALY AAPC were observed in Lesotho (3.97) and Zimbabwe (2.81). In contrast, the Maldives and Kuwait showed significant declines, with AAPCs of -5.75 and -4.52 respectively. Similar trends across countries were noted for both YLL and YLD rates. Globally, YLD rate showed a slight decrease with an AAPC of -0.014 (p=0.74) while YLL declined significantly (AAPC: -1.00, p<0.0001). Between 1990 and 2021, the global incidence of CC in individuals aged 25 and above decreased from 30.77 to 27.80 per 100,000, with an AAPC of -0.29 (95% CI: -0.39 to -0.19, p<0.0001). The highest incidence was observed in Kiribati, while the lowest were in Palestine, Kuwait, and Egypt. Significant increases in AAPC were noted in Lesotho, Italy and Zimbabwe. Conversely, the Maldives and Kuwait reported the highest fall in incidence. During the same period, the global prevalence of CC slightly increased from 135.96 to 140.22 per 100,000, with an AAPC of 0.18 (95% CI: 0.10 to 0.26, p<0.0001). The highest prevalence rates were reported in Palau, Venezuela, and Saint Vincent and the Grenadines, while the lowest were in Palestine and Egypt. Significant increases in AAPC were observed in Lesotho (4.80) and Italy (3.87). Conversely, Kuwait and Taiwan reported significant declines, with AAPCs of -3.46 and -3.44 respectively. Conclusions: Globally, mortality has slightly decreased, along with reductions in morbidity indicators such as YLD, DALY, and YLL. Although the global incidence of CC has declined modestly, its prevalence has increased. Notably, mortality and prevalence have increased substantially in Lesotho and Italy. Further research is essential to understand and address these regional variations and their underlying causes.