Future landscapes of women's hormone-sensitive cancers: unraveling global trends, age stratification, and regional inequities (1990-2035).

BACKGROUND

Hormone-sensitive cancers (HSCs) pose a significant threat to women's health, with global rising incidence rates. This study provides the most up-to-date assessment of the global burden of HSCs.

METHODS

We retrieved HSC burden data from the Global Burden of Disease (GBD) study (1990-2021), categorized by age groups, and extracted risk factors linked to HSC mortality. Age-standardized incidence (ASIR), Age-standardized death (ASDR), and Age-standardized DALY rates (ASDiR), along with estimated annual percentage changes (EAPC), were used to evaluate HSC burden. Decomposition analysis identified contributing factors, while inequality and frontier analyses highlighted regional disparities and burden reduction potential across social development levels. The Bayesian Age-Period-Cohort (BAPC) model forecasted HSC burden trends to 2035.

RESULTS

From 1990 to 2021, the reproductive age group showed the fastest increase in ASIR for HSCs (EAPC = 0.44, 95% CI: 0.38-0.49), whereas the elderly adult group experienced a slight decline (EAPC = -0.07, 95% CI: -0.14-0.01). Both ASDR and ASDiR decreased across all age groups. For ASDR, the EAPCs were -0.52 (CI: -0.61-0.42) in reproductive age group, -0.61 (CI: -0.65-0.56) in pre-elderly adults, and -0.61 (CI: -0.65-0.56) in elderly adults. The corresponding EAPCs for ASDiR were -0.43 (CI: -0.52-0.33), -0.54 (CI: -0.59-0.50), and -0.61 (CI: -0.65-0.56), respectively. In 2021, breast cancer (BC) was the dominant HSC subtype, with ASIRs of 28.81 (UI: 26.84-30.94), 141.92 (UI: 132.94-152.15), and 194.89 (UI: 159.93-212.76) per 100,000 in reproductive, pre-elderly and elderly groups, respectively. ASIR increased with higher socio-demographic index (SDI), whereas ASDR and ASDiR rose initially then declined with increasing SDI. Dietary risks, alcohol use, and tobacco were the leading contributors to BC burden. The contribution of high fasting plasma glucose to BC increased globally among the reproductive-age women, while high body mass index (BMI) showed rising contribution to ovarian and uterine cancer burden in middle- to low-SDI regions. BAPC projections suggest that these trends are likely to continue through 2035.

CONCLUSIONS

The global burden of HSCs continues to increase, with notable age and regional disparities in incidence and mortality. Lower SDI countries face faster-growing rates compared to higher SDI countries, a trend projected to persist through 2035.