Analysis and prediction of incidence and mortality of gynecological tumors in China based on age-period-cohort model
10.3760/cma.j.cn115355-20240227-00087
- VernacularTitle:基于年龄-时期-队列模型的中国妇科肿瘤发病和死亡分析及趋势预测
- Author:
Yuping WANG
1
;
Ni LI
;
Wenjuan ZHENG
;
Meili SI
;
Yufeng LIU
Author Information
1. 西安交通大学第一附属医院榆林医院妇产科，榆林 719000
- Keywords:
Genital neoplasms, female;
Incidence;
Mortality;
Age-period-cohort model
- From:
Cancer Research and Clinic
2024;36(9):652-658
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and mortality of gynecological tumors in China from 1990 to 2019, and explore the impact of age, period and birth cohort on the incidence and mortality of gynecological tumors, and predict the incidence and mortality trends of gynecological tumors, so as to provide references for formulating the prevention and control strategies of gynecological tumors.Methods:Based on the Global Burden of Disease Study 2019 (GBD 2019) database, the Joinpoint regression model was used to analyze the change trends of standardized incidence rates and mortality rates of cervical cancer, uterine cancer and ovarian cancer in China. The age, period and cohort effects of the incidence and mortality of 3 gynecological tumors were analyzed by using R software based on age-period-cohort model. The grey forecast model (GM) (1, 1) was used to fit the trends of incidence rates and mortality rates of 3 gynecological tumors, and predict the incidence rates and mortality rates from 2020 to 2034.Results:From 1990 to 2019, the standardized incidence rates of cervical cancer, uterine cancer and ovarian cancer showed upward trends in China, the standardized incidence rates increased from 8.41/100 000, 5.13/100 000 and 2.56/100 000 in 1990 to 11.01/100 000, 6.39/100 000 and 4.54/100 000 in 2019, the average annual percent changes (AAPC) were 0.9 % (95% CI: 0.8%-1.1%), 0.8 % (95% CI: 0.6%-1.0%) and 2.0 % (95% CI: 1.9%-2.1%), respectively, and the differences were statistically significant (all P < 0.001). The standardized mortality rate of ovarian cancer showed an increasing trend year by year, the standardized mortality rate increased from 1.76/100 000 in 1990 to 2.77/100 000 in 2019, with the AAPC of 1.6 % (95% CI: 1.4%-1.7%), while the standardized mortality rates of uterine cancer and cervical cancer showed decreasing trends year by year, the standardized mortality rates decreased from 2.38/100 000 and 5.85/100 000 in 1990 to 1.17/100 000 and 5.13/100 000 in 2019, with the AAPC of -2.4 % (95% CI: -2.6% - -2.3%) and -0.4 % (95% CI: -1.6% - -0.3%), respectively, and the differences were statistically significant (both P < 0.001).The analysis of age effect showed that the incidence rates and mortality rates of cervical cancer, uterine cancer and ovarian cancer showed gradual upward trends with age, reaching a peak in the ≥85 years old group. The analysis of period effect showed that the incidence risk of cervical cancer and uterine cancer decreased firstly, then increased and then decreased, and the incidence risk of cervical cancer and uterine cancer was the highest in 1990-1994 ( RR = 1.04, 95% CI: 0.86-1.27) and 2005-2009 ( RR = 1.08, 95% CI: 0.88-1.31), respectively. The incidence risk of ovarian cancer increased firstly and then decreased, and the incidence risk of ovarian cancer was the highest in 2000-2004 ( RR = 0.96, 95% CI: 0.71-1.30). The mortality risk of cervical cancer showed a trend of decreasing firstly, then increased and then decreased, and the mortality risk was the highest in 1990-1994 ( RR = 1.22, 95% CI: 0.86-1.27). The mortality risk of uterine cancer showed a trend of decreasing year by year, and the mortality risk was the highest in 1990-1994 ( RR = 1.26, 95% CI: 0.85-1.87). The mortality risk of ovarian cancer showed a trend of increasing firstly and then decreased, and the mortality risk was the highest in 1990-1994 ( RR = 1.01, 95% CI: 0.69-1.48). Cohort effect analysis showed that the risk of incidence and mortality of cervical cancer, uterine cancer and ovarian cancer showed a gradually decreasing trend except for a small fluctuation in individual birth cohorts, but the birth cohort 1990-1994 showed a rebound trend. The GM results showed that the overall incidence rates of cervical cancer, uterine cancer and ovarian cancer in China were increased year by year. In addition to the mortality rate of uterine cancer at a stable level, the mortality rates of cervical cancer and ovarian cancer showed upward trends. Conclusions:The disease burden of gynecological tumors in China is still heavy. Age, period and birth cohort effects affect the incidence and mortality of cervical cancer, uterine cancer and ovarian cancer to varying degrees.
