Age-period-cohort analysis of global, regional, and national cervical cancer prevalence trends in women of childbearing age (15-49 years), 1990-2021.

Abstract

Purpose: Cervical cancer remains a significant global health challenge, particularly among women of childbearing age (15-49 years). Recent data indicate a steady rise in cervical cancer incidence and mortality. This study investigates how age, period, and cohort affect cervical cancer prevalence worldwide from 1990 to 2021, with a focus on regional variations in burden based on the socio-demographic index (SDI).

Methods: The analysis used data from the 2021 Global Burden of Disease (GBD) Study, which provided age-standardized rates of incidence, mortality, disability-adjusted life years, and prevalence across 204 countries. We evaluated the age-standardized prevalence rate (ASPR) of cervical cancer in women aged 15-49 years using Joinpoint regression and an age-period-cohort framework to assess the influence of age, time period, and generational effects.

Results: From 1990 to 2021, the global ASPR for cervical cancer increased from 91.60 per 100,000 (95% UI: 86.20-97.40) to 105.00 per 100,000 (95% UI: 96.40-114.00). The total number of cases worldwide increased from 1.23 million (95% UI: 1.15-1.30) in 1990 to 2.05 million (95% UI: 1.88-2.23) in 2021. Using Joinpoint regression, we identified distinct trends in ASPR among women aged 15-49 years over the study period, with varying patterns of increase or decline across regions with different SDI levels, reflecting complex socioeconomic and healthcare influences. The highest prevalence was found in women aged 40-44 years, with this age group exhibiting the peak prevalence. The cohort effects had the most significant impact in middle-SDI and lower-SDI regions due to disparities in healthcare infrastructure and prevention efforts.

Conclusions: The rising global prevalence of cervical cancer highlights the growing challenge this disease presents, particularly in low-resource settings, where significant difficulties remain. Our age-period-cohort analysis highlights significant regional variations, emphasizing the need for enhanced access to HPV vaccination and screening, particularly in lower-SDI regions. This study underscores the critical necessity for global efforts to reduce cervical cancer rates and strengthen preventive healthcare measures.