1990年至2021年50岁及以上女性子宫癌的全球、区域和国家负担：全球疾病负担研究2021的系统分析

Global, regional, and national burden of uterine cancer among women aged 50 years and older from 1990 to 2021: a systematic analysis for the global burden of disease study 2021.

作者信息

Feng Tingting, Li Wei, Wang Qin, Yang Jing, Shen Fujin

机构信息

Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

J Health Popul Nutr. 2025 Jun 18;44(1):208. doi: 10.1186/s41043-025-00915-1.

BACKGROUND

Uterine cancer poses a growing global health threat, with rising incidence among women aged ≥ 50 years. This study aimed to evaluate its disease burden across regions and nations.

METHODS

Using Global Burden of Disease 2021 data, we analyzed the incidence, mortality, disability-adjusted life years (DALYs), and trends via estimated annual percentage change (EAPC), decomposition, inequality analyses, and Bayesian Age-Period-Cohort modeling for 2022-2040 projections.

RESULTS

In 2021, global uterine cancer cases among women ≥ 50 years reached 414,754 (95% UI: 370,388-453,502), causing 90,509 deaths (95% UI: 78,633-101,441) and 2,189,261 DALYs (95% UI: 1,920,396-2,446,737). Age-standardized incidence rate (ASIR) rose (EAPC = 0.56, 1990-2021), while mortality and DALYs declined. High-income North America had the highest ASIR (128/100,000), with the United States, China and Russia leading new cases. High Socio-demographic index (SDI) regions exhibited widening disparities, evidenced by a 21% increase in the slope index of inequality (SII) for incidence (47 in 1990 to 57 in 2021) and concentration indices (CI) rising from 0.33 (95% CI: 0.28, 0.37) in 1990 to 0.35 (95% CI: 0.29, 0.4) in 2021. Population growth drove 132.55% of DALY changes, outweighing epidemiological (-32.95%) and aging (0.4%) factors. Projections suggest declining ASIR, the age-standardized mortality rate (ASMR), and DALY rates by 2040, yet absolute cases will rise to 617,571 new cases, 131,961 deaths, and 2,851,768 DALYs.

CONCLUSIONS

Despite declining mortality and DALY rates, uterine cancer incidence continued to increase globally, driven by population growth. High-income regions faced disproportionate burdens, with persistent health inequities. Projected absolute case growth demands urgent prioritization of equity-oriented screening, prevention, and resource allocation. Governments must integrate targeted interventions with global aging policies to address this dual burden of epidemiological transition and health inequity.

背景

子宫癌对全球健康构成的威胁日益增大，在50岁及以上女性中的发病率不断上升。本研究旨在评估其在不同地区和国家的疾病负担。

方法

利用《2021年全球疾病负担》数据，我们通过估计年度百分比变化（EAPC）、分解分析、不平等分析以及贝叶斯年龄-时期-队列模型对2022 - 2040年进行预测，分析了发病率、死亡率、伤残调整生命年（DALYs）及趋势。

结果

2021年，50岁及以上女性的全球子宫癌病例达414,754例（95%不确定区间：370,388 - 453,502例），导致90,509例死亡（95%不确定区间：78,633 - 101,441例）和2,189,261个伤残调整生命年（95%不确定区间：1,920,396 - 2,446,737个）。年龄标准化发病率（ASIR）上升（1990 - 2021年EAPC = 0.56），而死亡率和伤残调整生命年下降。高收入的北美地区年龄标准化发病率最高（128/100,000），美国、中国和俄罗斯的新发病例数领先。高社会人口指数（SDI）地区的差距不断扩大，发病率不平等斜率指数（SII）增加21%（从1990年的47增至2021年的57）以及集中指数（CI）从1990年的0.33（95%置信区间：0.28, 0.37）升至2021年的0.35（95%置信区间：0.29, 0.4）可证明这一点。人口增长推动了132.55%的伤残调整生命年变化，超过了流行病学因素（-32.95%）和老龄化因素（0.4%）。预测表明，到2040年年龄标准化发病率、年龄标准化死亡率（ASMR）和伤残调整生命年率将下降，但绝对病例数将增至617,571例新发病例、131,961例死亡和2,851,768个伤残调整生命年。

结论

尽管死亡率和伤残调整生命年率下降，但受人口增长推动，全球子宫癌发病率仍在持续上升。高收入地区面临不成比例的负担，健康不平等现象持续存在。预计绝对病例数的增长迫切需要优先进行以公平为导向的筛查、预防和资源分配。各国政府必须将有针对性的干预措施与全球老龄化政策相结合，以应对流行病学转变和健康不平等的双重负担。