Global burden, temporal trends and cross-national inequalities of the comorbidity between depressive disorder and hormone-dependent tumors in women of reproductive ages from 1990 to 2021: A population-based analysis with projections to 2036.

BACKGROUND

This study aimed to analyze the global comorbidity burden of depressive disorder (DD) and hormone-dependent tumors (HDTs), including breast cancer (BC), ovarian cancer (OC), and uterine cancer (UC), among women of reproductive ages (WRAs) using Global Burden of Disease (GBD) 2021 data.

METHODS

Long-term trends between 1990 and 2021 in the incidence, prevalence, and disability-adjusted life years (DALYs) of the comorbidity burden were used Joinpoint regression analysis. Future trends to 2036 were projected via a Bayesian age-period-cohort (BAPC) model. Age-period-cohort (APC) model to dissect temporal trends, decomposition analysis to quantify the contributions of demographic changes, and cross-country inequality and frontier analyses to evaluate socio-economic disparities and improvement potential across nations.

RESULTS

From 1990 to 2021, the age-standardized incidence rate (ASIR) and prevalence rate (ASPR) of the comorbidity burden of DD and HDTs increased globally, while the age-standardized DALYs rate (ASDALYsR) decreased. The APC model identified women aged 45-49 years as bearing the most stable and high-risk burden. Decomposition analysis revealed that population growth and epidemiological changes were the primary drivers of the increasing burden. Cross-country inequality analysis indicated that high-SDI countries shouldered a greater comorbidity burden, yet the gap with low-SDI regions was narrowing. Frontier analysis suggested that high-SDI regions possessed the largest potential for burden reduction.

CONCLUSIONS

The comorbidity burden of DD and HDTs among WRAs is projected to continue rising over the next 15 years. Public health efforts must prioritize high-risk age groups and high-SDI regions, integrating depression screening and management into oncologic care to mitigate this growing dual burden.