Cervical, Uterine, and Ovarian Cancers in Chinese Women Aged 55 Years and Older: Burden, Temporal Trends, Risk Attribution, and Future Projections From the Global Burden of Disease Study 2021.

AIM: To compare the burden, temporal trends, risk factor attribution, and future projections of cervical, uterine, and ovarian cancers among Chinese women aged 55 years and older.

METHODS

We conducted a population-based descriptive and projection analysis using data from the Global Burden of Disease Study 2021. Incidence, mortality, disability-adjusted life years (DALYs), and corresponding age-standardized rates for cervical, uterine, and ovarian cancers were extracted for 1990-2021. Age-specific burden, temporal trends, and attributable risk factors were examined. Incidence and mortality from 2022 to 2036 were projected using a Bayesian age-specific trend model.

RESULTS

From 1990 to 2021, the absolute numbers of incident cases, deaths, and DALYs increased for all three cancers among Chinese women aged 55 years and older, whereas age-standardized mortality and DALY rates generally declined. In 2021, cervical cancer showed the highest overall burden, with mortality rates increasing markedly in the oldest age groups. Uterine cancer showed the largest increase in incidence age-standardized rate and a burden concentrated mainly in the younger segment of older women. Ovarian cancer showed a relatively unfavorable mortality pattern and was projected to have increasing incidence and mortality through 2036. Risk attribution differed by cancer type: cervical cancer mortality was mainly attributable to unsafe sex, uterine cancer mortality to high body mass index, and ovarian cancer mortality to mixed metabolic and environmental or occupational risks.

CONCLUSION

Cervical, uterine, and ovarian cancers remain substantial and heterogeneous health burdens among older Chinese women. Despite declines in age-standardized mortality and DALY rates, population aging is likely to increase the absolute burden. Age-specific prevention, screening, early detection, and resource allocation are needed for older women in China.