Background: Malignant tumors of reproductive system seriously threaten women's life and health. We analyzed the changes in mortality and disease burden of cervical cancer, uterine cancer and ovarian cancer in China from 2006 to 2020 to provide a basis for formulating scientific prevention and control measures.
Methods: Annual death data for cervical cancer, uterine cancer and ovarian cancer were collected from the Chinese Cause of Death Surveillance. The crude mortality rate (CMR), age-standardized mortality rate (ASMR), annual percentage change (APC), and average APC (AAPC) were applied to analyze the trend of mortality. Loss of life expectancy (LLE) and years of life lost (YLL) were used to assess disease burden.
Results: From 2006 to 2020, there was no significant change in the total ASMR and standardized YLL rates of malignant tumors of the reproductive system, leading to an average LLE of 0.18 years. The YLL rate was the highest in the 55-59 age group. The mortality rate and disease burden of the three types of cancer have changed from uterine cancer higher than cervical cancer and ovarian cancer in 2006 to cervical cancer higher than ovarian cancer and uterine cancer in 2020. The ASMR and standardized YLL rate of uterine cancer showed a downward trend, and AAPC was - 5.21% (- 9.31% ~ - 0.91%) and - 6.07% (- 9.45% ~ - 2.58%), respectively. The mortality rates of cervical cancer and ovarian cancer remain high.
Conclusion: The mortality and disease burden of malignant tumors of the female reproductive system in China are still at a high level. It is necessary to improve screening and prevention strategies as soon as possible, improve the techniques of diagnosis and treatment, and take adequate measures to protect women's life and health.
Keywords: Disease burden; Female reproductive system; Malignant tumor; Mortality.
Malignant tumors of the female reproductive system are the leading causes of women's mortality worldwide, mainly including cervical cancer, uterine cancer and ovarian cancer. Numerous studies have reported mortality changes in the three primary reproductive system cancers among different countries, with inconsistent temporal trends. In 2020, almost 17.51% of malignant tumors of the female reproductive system deaths occurred in China because of the large population base and severe aging. However, there are limited studies on the disease burden of malignant tumors of the female reproductive system in China. This study analyzed the mortality, YLL and LLE of cervical cancer, uterine cancer and ovarian cancer using the National Death Cause Surveillance Dataset from 2006 to 2020. The findings revealed that mortality and disease burden of malignant tumors of the reproductive system showed no significant change. The mortality and disease burden of uterine cancer decreased significantly, but that of cervical cancer and ovarian cancer remain high. Cervical cancer has a higher mortality and disease burden than uterine cancer and ovarian cancer, making it the most severe malignant tumor of the female reproductive system. Screening and HPV vaccination will reduce the mortality and disease burden of cervical cancer in China, but this effect will take many years to manifest. Screening and prevention strategies for high-risk groups of uterine cancer and ovarian cancer should be established as soon as possible. In summary, the management and monitoring of malignant tumors of the female reproductive system should be strengthened.
© 2022. The Author(s).