Liu Xingyu, Wang Bo, Zhang Qianyu, Zhang Jinjin, Wang Shixuan
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
National Clinical Research Center for Obstetrical and Gynecological Diseases, Huazhong University of Science and Technology, Wuhan, China.
Front Physiol. 2023 Jun 22;14:1197658. doi: 10.3389/fphys.2023.1197658. eCollection 2023.
Uterine fibroids occur in 40%-60% of women and are symptomatic in 30% of the patients by causing abnormal uterine bleeding, pelvic pressure, pain, and infertility. The study aims to evaluate the long-term trend of uterine fibroids mortality and disability-adjusted life years (DALYs) in China and the relative risks of age, period, and birth cohort effects. The mortality and DALYs of uterine fibroids from 1990 to 2019 were derived from the Global Burden of Disease 2019. The annual percentage change and average annual percent change (AAPC) were assessed using the Joinpoint regression. The effects of age, period, and birth cohort on death and DALYs were analyzed by the Age-Period-Cohort framework. The age-standardized rates were all on the ascending trend, with the greatest increase in the age-standardized mortality rate (AAPC, 1.53; 95% CI, 1.04-2.02). The net drift was found to be 3.51% (95% CI, 2.25%-4.78%) per year for mortality and 0.34% (95% CI, 0.14%-0.53%) per year for DALYs. Significant age, period, and birth cohort effects were found for mortality and DALYs ( < 0.001 for all). The mortality risk increased overall with age, but the DALYs risk increased first and then decreased with age. The period and birth cohort risks for mortality and DALYs showed different trends. These secular time trends and changes of mortality and DALYs reveal the socioeconomic alterations, reform of diagnosis and therapy, and changes in social lifestyles and behaviors. Uterine fibroids are still the most common benign gynecological tumors in women, and more epidemiological investigations and social health prevention and control should be applied.
子宫肌瘤在40%-60%的女性中出现，30%的患者会出现症状，表现为子宫异常出血、盆腔压迫感、疼痛和不孕。该研究旨在评估中国子宫肌瘤死亡率和伤残调整生命年（DALYs）的长期趋势以及年龄、时期和出生队列效应的相对风险。1990年至2019年子宫肌瘤的死亡率和DALYs数据来自《2019年全球疾病负担》。使用Joinpoint回归评估年度百分比变化和平均年度百分比变化（AAPC）。通过年龄-时期-队列框架分析年龄、时期和出生队列对死亡和DALYs的影响。年龄标准化率均呈上升趋势，其中年龄标准化死亡率上升幅度最大（AAPC，1.53；95%CI，1.04-2.02）。发现死亡率的净漂移为每年3.51%（95%CI，2.25%-4.78%），DALYs为每年0.34%（95%CI，0.14%-0.53%）。在死亡率和DALYs方面发现了显著的年龄、时期和出生队列效应（所有P<0.001）。死亡率风险总体上随年龄增加，但DALYs风险随年龄先增加后降低。死亡率和DALYs的时期和出生队列风险呈现不同趋势。这些长期时间趋势以及死亡率和DALYs的变化揭示了社会经济变化、诊断和治疗的改革以及社会生活方式和行为的变化。子宫肌瘤仍然是女性中最常见的良性妇科肿瘤，应开展更多的流行病学调查以及社会健康预防和控制工作。
