Disease burden, changing trends of Cervical cancer and its risk factors among women in mainland China, 1990-2019

Purpose: To explore the trend of the disease burden of cervical cancer in Chinese women from 1990 to 2019 and analyze the relevant risk factors. Methods: Based on the open data of the Global Burden of Disease (GBD) 2019, the disease burden of cervical cancer in Chinese women was analyzed by age from 1990 to 2019. Joinpoint was employed to calculate the annual percentage change (APC) and the average annual percentage change (AAPC) of the standardized incidence, mortality, and disability-adjusted life year (DALY) rates of cervical cancer. Moreover, the associated risk factors were analyzed with the GBD database. Results: From 1990 to 2019, the standardized incidence rate presented an increasing trend, with an average annual increase of 0.95%. In contrast, both the standardized DALY rate and the mortality rate showed a decreasing trend, with an AAPC of -0.32% and -0.45%, respectively. In all age groups, the Years of life lost (YLL) rate and the DALY rate exhibited a decreasing trend. The age group with the highest incidence rate shifted from 70 - 74 years in 1990 to 55 - 59 years in 2019. According to the GBD database, the risk factors contributing to the mortality and DALY rates were all behavioral risk factors, namely smoking and unsafe sex respectively. HPV infection is a risk factor for almost all cervical cancers, and both smoking and unsafe sex can increase the risk of HPV infection. Conclusions: The disease burden of cervical cancer among women in mainland China remains severe, and there is a long way to go in prevention and treatment. Screening for cervical cancer, HPV vaccination, and further treatment measures are urgently needed to reduce the burden of disease.