Assessing the contribution of metabolic risk factors to uterine cancer-related deaths and predictions until 2030 and 2050.

Abstract

e17642 Background: The incidence of uterine cancer has been rising globally, particularly in Western countries. This could be due to an unhealthy lifestyle, leading to increased metabolic risk factors. Methods: Age-stratified mortality rates (ASMRs) of uterine cancer from 1990-2021 were collected from the Global Burden of Diseases database 2021. Further, deaths due to all metabolic risk factors were extracted as rates per 100,000 population. Dataset was further stratified across 55 GBD-defined regions. A linear regression model was built to predict death rates attributable to each risk factor till 2030, and 2050. Annual percentage change (APC) was calculated to estimate the change in risk-attributable death rates across 1990-2021, 2021-2030, and 2021-2050. Statistical significance was defined at p<0.05. Results: Global total number of deaths due to uterine cancer in 2021 was 97,672, which is projected to rise to 103,302 in 2030 and 129292 in 2050. Average APC indicate a rising trend 1990-2021(1.79; 95%CI: 1.68, 1.89; p<0.0001), followed by a slight reduction in slope from 2021 to 2030 (0.98; 95%CI, 0.53, 1.44, P<0.0001), and then a steep incline till 2050 (1.12; 95%CI, 1.1, 1.14; p<0.0001). Highest number of deaths due to metabolic risk factor-related uterine cancer was in World Bank High Income regions and Advanced Health Systems, with higher numbers in 2050 (20,547, 26,366 respectively) than 2030 (15,551, 20,506 respectively). Metabolic risk factors contributed to highest increase in mortality till 2021 in Southern African (AAPC: 1.33, 95%CI: 1.18, 1.48) and Caribbean regions (APC: 1.09), closely followed by Commonwealth (APC: 0.81) and High-income regions in North America (APC: 0.78). From 1990-2021, only Central Asia (APC: -0.29; 95%CI, -0.45, -0.15) and Southern Latin America (APC: -0.27) noted a decline in deaths due to metabolic risk factors. From 2021-2030, the top regions with the highest ASMRs due to metabolic risks were similar. Significant declines were noted in similar regions, with Eastern Europe (APC: -0.29) starting to show an insignificant decline as opposed to its positive APC till 2021 (APC: 0.16). From 2021-2050, similar trends were observed, except gradual inclines in Tropical Latin America (APC: 0.01). Conclusions: Despite the high overall rates of Southern Africa and Caribbean regions, an overall decline in the AAPC has been noted. This implies a predicted decline in mortality rates in these regions. Conversely, the decline in mortality in Central Asia and Latin American has stagnated, which may indicate a rise after 2050. This indicates a gradual shift in high burden countries, from African countries to Asian, European and Latin American Regions. These trends indicate an urgent need to identify causes for the rise in metabolic risk factors, and to enable policies for early screening and diagnosis in these regions.