Burden of women's cancers in the group of twenty (G20) from 1990 to 2023: epidemiological trends and impact from fertility, quality of care, and survival.

Cancer in women represents a significant disease burden, posing challenges for prevention, treatment, and caregiving. This study aimed to analyze the epidemiological trends of the women's cancer burden and the main influencing factors in the group of twenty (G20) from 1990 to 2023.

Incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for breast, cervical, uterine, and ovarian cancers, as well as fertility rates for G20 and its 98 locations, were sourced from the Global Burden of Disease Study 2023. Age-standardized rates (ASRs), quality of care index (QCI), and 5-year relative survival of integrated women's cancers were calculated. Average annual percent changes (AAPCs) were used to determine the temporal trends by age and region. Decomposition analysis identified drivers of changes in case numbers, linear regression assessed the associations with DALY rate changes, and dominance analysis identified dominant predictors.

In 2023, the incidence, prevalence, mortality, and DALYs from women's cancers in G20 were 3.29 [95% uncertainty interval (UI) 2.60-4.14], 26.71 (95% UI 21.99-32.40), 1.16 (95% UI 0.91-1.45), and 36.58 million (95% UI 28.40-46.32), respectively, with ASRs of 87.63/100,000 (95% UI 65.12-115.85), 706.16/100,000 (95% UI 555.75-890.02), 30.03/100,000 (95% UI 22.10-39.58), and 994.79/100,000 (95% UI 728.43-1328.81). The QCI was 75.13 [95% confidence interval (CI) 73.67-76.59], and the 5-year relative survival was 65.74% (95% CI 65.53-65.95). From 1990 to 2023, there was a significant increase in incidence, prevalence, mortality, and DALYs in G20, primarily driven by population growth. Age-standardized incidence rate, QCI, and 5-year relative survival increased, while age-standardized mortality and DALY rates decreased. Changes in prevalence rates of breast cancer and cervical cancer for women aged 15-49 years were positively associated with changes in DALY rates of women's cancers, whereas changes in the total fertility rate were negatively associated. Dominance analysis confirmed these three factors consistently as dominant predictors between 1990 and 2023. Reducing the prevalence of breast and cervical cancers and increasing fertility among women aged 15-49 years could lower the overall DALY burden attributable to women's cancer.

The incidence, prevalence, mortality, and DALYs of women's cancers in G20 have increased substantially from 1990 to 2023. Tailored prevention strategies should consider age and cancer type, emphasizing reproductive health for women of reproductive age.
Non-Communicable Diseases
Cancer
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Authors

Li Li, Tang Tang, Wang Wang, Qi Qi, He He, Guan Guan, Li Li, Wu Wu, Asihaer Asihaer, Vermund Vermund, Hu Hu
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