Table 1_Cervical cancer burden and attributable risk factors across different age and regions from 1990 to 2021 and future burden prediction: results from the global burden of disease study 2021.doc

BackgroundCervical cancer (CC) is a global public health problem. We aimed to evaluate the global and regional CC burden between 1990 and 2021, identify the attributable risk factors, and project its burden up to 2035.
MethodsData were extracted from the Global Burden of Disease Study 2021, and the CC incidence, mortality, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), age-standardized disability-adjusted life years (DALYs), and attributable risk factors from 1990 to 2021 were analyzed. The impacts of geographical variations, different age groups, and the socio-demographic index (SDI) on CC morbidity and mortality measurements were assessed. The attributable risk factors to CC death and DALY were evaluated, and the incidence, mortality, and DALYs to 2035 were projected.
ResultsGlobally, the number of CC cases has increased from 409,548.49 cases in 1990 to 667,426.40 cases in 2021. However, the ASIR decreased from 18.11 to 15.32 per 100,000, with the greatest ASIR decrease in high SDI regions (estimated annual percentage change: -1.41). Between 1990 and 2021, the global ASDR decreased from 9.68 to 6.62 per 100,000, and the rate of age-standardized DALYs decreased from 330.11 to 226.28 per 100,000. However, these improvements were not consistent across different SDI regions. The CC incidence was the highest in the 55-59 age group, globally. The risk factors, which included unsafe sex and smoke, significantly varied by region. The global ASIR exhibited a downward trend from 2021 to 2035.
ConclusionFrom 1990 to 2021, although the overall trend in incidence, mortality, and DALYs of CC exhibited a global and regional downward trend, there were significant disparities among areas with different socioeconomic development. More efficient targeted prevention and management strategies, easy access to health care in less developed regions, and risk factor modifications should be promoted, in order to reduce the global burden of CC.

背景
宫颈癌（Cervical cancer, CC）是全球性公共卫生难题。本研究旨在评估1990年至2021年间全球及各地区的宫颈癌疾病负担，明确其可归因危险因素，并预测至2035年的疾病负担变化。
方法
研究数据提取自《2021年全球疾病负担研究》，分析了1990年至2021年间宫颈癌的发病、死亡、年龄标准化发病率（Age-Standardized Incidence Rate, ASIR）、年龄标准化死亡率（Age-Standardized Death Rate, ASDR）、年龄标准化伤残调整生命年（Disability-Adjusted Life Years, DALYs）及可归因危险因素。评估了地理差异、不同年龄组及社会人口指数（Socio-demographic Index, SDI）对宫颈癌发病与死亡相关指标的影响；分析了宫颈癌死亡及伤残调整生命年的可归因危险因素，并预测了至2035年的宫颈癌发病、死亡及伤残调整生命年情况。
结果
全球范围内，宫颈癌病例数从1990年的409548.49例增长至2021年的667426.40例。但年龄标准化发病率从每10万人18.11降至15.32，其中高社会人口指数（SDI）地区的年龄标准化发病率降幅最大（估计年百分比变化率为-1.41）。1990年至2021年间，全球年龄标准化死亡率从每10万人9.68降至6.62，年龄标准化伤残调整生命年率从每10万人330.11降至226.28。但上述改善在不同社会人口指数地区并不均衡。全球范围内，宫颈癌发病高峰集中于55~59岁年龄组。包括不安全性行为与吸烟在内的危险因素存在显著的区域差异。2021年至2035年，全球年龄标准化发病率呈下降趋势。
结论
1990年至2021年间，尽管全球及各地区宫颈癌的发病、死亡及伤残调整生命年整体均呈下降趋势，但不同社会经济发展水平地区间仍存在显著差异。为降低全球宫颈癌疾病负担，应推广更高效的靶向预防与管理策略、改善欠发达地区的医疗可及性，并加强危险因素干预。