Burden and risk factors of cervical cancer in Vietnam from 1990 to 2021 and forecasting to 2050-a systematic analysis from global burden disease.

BACKGROUND

Cervical cancer continues to be a significant global health challenge, with Vietnam facing similar concerns. Although there has been some progress in lowering its incidence and mortality rates, a comprehensive understanding of long-term trends and the factors driving these changes remains limited.

OBJECTIVE

This study aimed to analyze the burden and risk factors of cervical cancer in Vietnam over a 3-decade period, from 1990 to 2021 with projection to 2050.

STUDY DESIGN

Our study used data from the Global Burden of Disease (GBD) 2021 estimates, developed by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. This dataset includes metrics such as incidence, prevalence, mortality, and disability-adjusted life years (DALYs), all presented as age-standardized rates (ASRs) per 100,000 individuals. We analyzed trends from 1990 to 2021 and projections for 2022 to 2050 using the Joinpoint regression model. Additionally, we examined ASRs for death and DALYs attributed to cervical cancer-related risk factors.

RESULTS

In 2021, cervical cancer accounted for approximately 4369 deaths (95% UI: 3345-5713) in Vietnam, with ASRs for incidence, prevalence, and mortality at 16.50 per 100,000 (95% UI: 12.49-21.83), 88.11 per 100,000 (95% UI: 65.32-116.75), and 7.66 per 100,000 (95% UI: 5.90-9.94), respectively. From 1990 to 2021, trends in incidence, DALYs, and mortality followed 3 phases: a decrease in incidence from 1990 to 1992 (APC: -2.42%, 95% CI: -3.56 to -0.85), an increase from 1992 to 1996 (APC: 2.69%, 95% CI: 2.09-3.65), and a subsequent decrease from 1996 to 2008 (APC: -0.68%, 95% CI: -0.86 to -0.57), with no significant change from 2008 to 2021. Projections from 2022 to 2050 suggest an all-age DALYs rate of 147.55 (95% UI: 105.14-198.31) in 2050, with an expected rise until 2039 followed by a decline, reflecting an annual percent change of -0.2% (95% CI: -0.07 to -0.55). Major risk factors for cervical cancer in Vietnam include smoking and unsafe sexual practices, with associated age-standardized mortality rates of 0.31 (95% UI: 0.16-0.53) and 7.66 (95% CI: 5.89-9.80) per year, respectively.

CONCLUSION

The study reveals that, despite some progress in reducing the incidence, mortality, and DALYs associated with cervical cancer in Vietnam over the past 3 decades, the overall burden remains substantial. This study underscores the impact of key risk factors, including smoking and unsafe sex. Future research is needed to evaluate effective interventions and healthcare policies that could reduce the burden of cervical cancer and improve women's health outcomes in Vietnam.