The incident case, incidence rate, age-standardized rate (ASR) for incidence, prevalent case, prevalence rate, ASR for prevalence, number of YLDs, YLD rate, and ASR for YLDs were derived from the Global Burden of Disease 2019 (GBD 2019) study. We utilized an age-period-cohort (APC) model to estimate overall annual percentage changes in the rate of incidence, prevalence, and YLDs (net drifts), annual percentage changes from 10 to 14 years to 65-69 years (local drifts), period and cohort relative risks (period/cohort effects) between 1990 and 2019.
Globally, the incident cases, prevalent cases, and the number of YLDs of uterine fibroids increased from 1990 to 2019 with the growth of 67.07%, 78.82% and 77.34%, respectively. High Socio-demographic Index (SDI) and high-middle SDI quintiles with decreasing trends (net drift < 0.0%), and increasing trends (net drift > 0.0%) were observed in middle SDI, low-middle SDI, and low SDI quintiles in annual percentage change of incidence rate, prevalence rate and YLDs rate over the past 30 years. There were 186 countries and territories that showed an increasing trend in incidence rate, 183 showed an increasing trend in prevalence rate and 174 showed an increasing trend in YLDs rate. Moreover, the effects of age on uterine fibroids increased with age and peaked at 35-44 years and then declined with advancing age. Both the period and cohort effects on uterine fibroids showed increasing trend in middle SDI, low-middle SDI and low SDI quintiles in recent 15 years and birth cohort later than 1965.
The global burden of uterine fibroids is becoming more serious in middle SDI, low-middle SDI and low SDI quintiles. Raising awareness of uterine fibroids, increasing medical investment and improving levels of medical care are necessary to reduce future burden.
方法:事件案例,发病率,发病率的年龄标准化率(ASR),普遍的情况下,患病率,患病率的ASR,YLD的数量,YLD费率,YLD的ASR来自2019年全球疾病负担(GBD2019)研究。我们利用年龄-时期队列(APC)模型来估计发病率的总体年度百分比变化,患病率,和YLDs(净漂移),从10至14年到65至69年(局部漂移)的年度百分比变化,1990年至2019年期间和队列相对风险(期间/队列影响)。
结果:全球,事件案例,普遍的情况下,和子宫肌瘤的YLDs数量从1990年到2019年以67.07%的增长,78.82%和77.34%,分别。高社会人口指数(SDI)和中高SDI五分位数呈下降趋势(净漂移<0.0%),在中SDI观察到增加趋势(净漂移>0.0%),中低端SDI,和发病率的年百分比变化的低SDI五分位数,过去30年的患病率和YLDs率。有186个国家和地区的发病率呈现上升趋势,183例患病率呈上升趋势,174例YLDs患病率呈上升趋势。此外,年龄对子宫肌瘤的影响随着年龄的增长而增加,在35-44岁达到峰值,然后随着年龄的增长而下降。中期SDI对子宫肌瘤的周期和队列效应均呈增加趋势,最近15年中低SDI和低SDI五分位数,出生队列晚于1965年。
结论:在SDI中期,子宫肌瘤的全球负担越来越严重,中低SDI和低SDI五分位数。提高对子宫肌瘤的认识,增加医疗投资和提高医疗水平是减轻未来负担的必要条件。