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1990 - 2021年女性癌症全球负担:来自全球疾病负担研究(GBD)2021的系统分析

Global burden of cancer in women, 1990-2021: a systematic analysis from the GBD 2021 study.

作者信息

Mao Yun, Gao Yebo, He Yongjie, Wan Zuihui, Li Shuyu, Ding Zhixun, Hu Beier, Fu Ling, Luo Chao, Zhu Shijie, Cao Wen

机构信息

Department of Oncology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.

Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Front Oncol. 2025 Aug 11;15:1633894. doi: 10.3389/fonc.2025.1633894. eCollection 2025.

Abstract

OBJECTIVE

This study evaluates global burden, disparities, and trends of female cancers (breast, cervical, uterine, ovarian) from 1990 to 2021, and identifies key contributing factors and intervention strategies.

METHODS

Data from the Global Burden of Disease (GBD,1990-2021) Study and recent reports were analyzed to assess incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries stratified by Socio-demographic Index (SDI). Regression and spatiotemporal analyses explored links with risk factors (e.g., obesity, HPV) and healthcare access.

RESULTS

Breast cancer dominated the burden, with age-standardized incidence rates (ASIR) rising by 28% (2.08 million new cases in 2021), driven by lifestyle factors (high BMI, alcohol use) and showing a strong connection with higher SDI (r=0.82). Cervical cancer remained a critical challenge in low- and middle-income regions, showing a strong negative correlation with SDI(r = -0.75), though Age-Standardized Mortality Rate (ASMR) declined globally (-1.4% annual change). Uterine cancer incidence rose steadily (0.7% annual increase; 473,614 cases in 2021), primarily attributable to obesity, while ovarian cancer mortality remained high (207,000 deaths) due to late diagnosis. Key modifiable risks included HPV infection (85% of cervical cancers), tobacco use, and reproductive behaviors.

CONCLUSION

The global burden of female cancers presents a significant public health challenge. Disparities in female cancer burden reflect inequities in healthcare access and rising metabolic risks. Priority actions include HPV vaccination, low-cost screening, and obesity control. Equity-focused, data-informed policies are crucial to reduce global disparities.

摘要

目的

本研究评估1990年至2021年女性癌症(乳腺癌、宫颈癌、子宫癌、卵巢癌)的全球负担、差异及趋势,并确定关键影响因素和干预策略。

方法

分析全球疾病负担(GBD,1990 - 2021年)研究数据及近期报告,以评估204个国家按社会人口指数(SDI)分层后的发病率、死亡率及伤残调整生命年(DALYs)。回归分析和时空分析探讨了与风险因素(如肥胖、人乳头瘤病毒)及医疗保健可及性之间的联系。

结果

乳腺癌负担最重,年龄标准化发病率(ASIR)上升了28%(2021年新增208万例),主要由生活方式因素(高体重指数、饮酒)所致,且与较高的SDI呈强相关(r = 0.82)。宫颈癌在低收入和中等收入地区仍是重大挑战,与SDI呈强负相关(r = -0.75),不过全球年龄标准化死亡率(ASMR)有所下降(年变化率为 -1.4%)。子宫癌发病率稳步上升(年增长率0.7%;2021年有473614例),主要归因于肥胖,而卵巢癌死亡率因诊断延迟仍居高不下(20.7万例死亡)。主要可改变风险包括人乳头瘤病毒感染(85%的宫颈癌)、吸烟及生殖行为。

结论

女性癌症的全球负担构成了重大公共卫生挑战。女性癌症负担的差异反映了医疗保健可及性方面的不公平及代谢风险上升。优先行动包括人乳头瘤病毒疫苗接种、低成本筛查及肥胖控制。以公平为重点、基于数据的政策对于减少全球差异至关重要。

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