背景:本研究旨在评估1990年至2019年全球三种主要妇科癌症(GC)按社会人口统计学状况分层的负担的长期趋势。评估危险因素归因死亡率的趋势,并检查年龄的具体影响,period,在他们身后的不同地区。
方法:我们提取了死亡率数据,残疾调整寿命年(DALYs),和宫颈癌(CC)的年龄标准化率(ASR),子宫癌(UC),和卵巢癌(OC)与1990年至2019年的风险相关,作为GC负担指标。使用年龄期队列分析来分析归因死亡率的趋势。
结果:CC的死亡人数和DALY,UC和OC自1990年以来在全球范围内增加,ASDR有所下降。区域,2019年,CC的ASDR在低SDI地区最高,为15.05(11.92,18.46)/10万,而UC和OC的ASDR在高SDI地区最高,为2.52(2.32,2.64),和5.67(5.16,6.09)。不安全性行为导致CC死亡的风险随着年龄的增长而增加,然后逐渐稳定。地区差异。吸烟对CC死亡的周期效应呈下降趋势。高BMI导致UC死亡的队列效应在各地区均有所下降,尤其是在中期的早期,中低端和低SDI地区。
结论:三种GCs归因死亡率及其年龄的全球长期趋势,period,队列效应可以反映诊断和治疗进展,快速的社会经济转型,不同发展中地区生活方式和行为模式的变化。应根据不同国家的流行状况,采取预防和可控措施,提高对风险因素的认识,以减轻未来的负担。
BACKGROUND: This study aims to assess the long-term trends in the burden of three major gynecologic cancers(GCs) stratified by social-demographic status across the world from 1990 to 2019. To assess the trends of risk factor attributed mortality, and to examine the specific effects of age, period, cohort behind them in different regions.
METHODS: We extracted data on the mortality, disability-adjusted life years(DALYs), and age-standardized rates(ASRs) of cervical cancer(CC), uterine cancer(UC), and ovarian cancer(OC) related to risks from 1990 to 2019, as GCs burden measures. Age-period-cohort analysis was used to analyze trends in attributable mortality rates.
RESULTS: The number of deaths and DALYs for CC, UC and OC increased since 1990 worldwide, while the ASDRs decreased. Regionally, the ASDR of CC was the highest in low SDI region at 15.05(11.92, 18.46) per 100,000 in 2019, while the ASDRs of UC and OC were highest in high SDI region at 2.52(2.32,2.64), and 5.67(5.16,6.09). The risk of CC death caused by unsafe sex increased with age and then gradually stabilized, with regional differences. The period effect of CC death attributed to smoking showed a downward trend. The cohort effect of UC death attributed to high BMI decreased in each region, especially in the early period in middle, low-middle and low SDI areas.
CONCLUSIONS: Global secular trends of attributed mortality for the three GCs and their age, period, and cohort effects may reflect the diagnosis and treatment progress, rapid socioeconomic transitions, concomitant changes in lifestyle and behavioral patterns in different developing regions. Prevention and controllable measures should be carried out according to the epidemic status in different countries, raising awareness of risk factors to reduce future burden.