Rising burden and deepening inequalities: a national study of high BMI-related uterine cancer in the United States using GBD and NHANES data.

IF 4.2 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of Gynecologic Oncology Pub Date : 2026-08-06 DOI:10.3802/jgo.2027.38.e12

Ju Huang, Xinhui Wu, Dingwen Xu, Huishen Yan, Zhe Yang, Zhongwei Jia

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引用次数: 0

Abstract

Objective: Uterine cancer mortality is rising in the U.S. while other cancer deaths decline, posing a major public health challenge. High BMI is the strongest modifiable risk factor, but its full burden and associated inequalities remain poorly characterized.

Methods: Using data from Global Burden of Disease 2023 and National Health and Nutrition Examination Survey (NHANES, 1999-2023), we assessed national and state-level trends in uterine cancer mortality (age-standardized mortality rate [ASMR]) and disability-adjusted life years (age-standardized disability-adjusted life year rate [ASDR]) from 1990-2023. We employed Joinpoint regression, frontier analysis, and AutoRegressive Integrated Moving Average forecasting. Individual-level BMI associations were evaluated using weighted multivariable logistic regression.

Results: The ASMR and ASDR for high BMI-related uterine cancer in the U.S. significantly exceeded global averages, with the gap widening. The fastest increase occurred during 2009-2017. Significant geographic disparities were identified; West Virginia and Mississippi were consistent hotspots with high burden and rapid growth. A state's socio-demographic index was negatively correlated with the growth rate (estimated annual percentage change) of ASMR (ρ=-0.709) and ASDR (ρ=-0.726), indicating faster deterioration in socioeconomically disadvantaged regions. NHANES analysis confirmed a significant, dose-response relationship between BMI and uterine cancer risk (adjusted odds ratio per 1-unit BMI increase=1.03, 95% confidence interval=1.01-1.06), which strengthened over time. Subgroup analyses revealed stronger associations in obese individuals, non-Hispanic whites, and women aged ≥50 years.

Conclusion: High BMI drives the rising and unequal uterine cancer burden in the U.S., underscoring the urgent need for interventions targeting both obesity and health inequities.

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负担增加和不平等加深：美国使用GBD和NHANES数据对高bmi相关子宫癌的国家研究

目的：子宫癌死亡率在美国上升，而其他癌症死亡率下降，构成了一个重大的公共卫生挑战。高体重指数是最强的可改变的风险因素，但其全部负担和相关的不平等仍然不清楚。方法：使用《全球疾病负担2023》和《国家健康与营养调查》（NHANES, 1999-2023）的数据，评估1990-2023年国家和州一级子宫癌死亡率（年龄标准化死亡率[ASMR]）和残疾调整生命年（年龄标准化残疾调整生命年率[ASDR]）的趋势。我们采用了连接点回归、前沿分析和自回归综合移动平均预测。使用加权多变量logistic回归评估个体水平BMI的相关性。结果：美国高bmi相关子宫癌的ASMR和ASDR均明显超过全球平均水平，且差距不断扩大。增长最快的是2009-2017年。发现了显著的地理差异；西弗吉尼亚州和密西西比州一直是高负担和快速增长的热点地区。一个州的社会人口指数与ASMR （ρ=-0.709）和ASDR （ρ=-0.726）的增长率（估计的年百分比变化）呈负相关，表明社会经济条件较差的地区恶化更快。NHANES分析证实，BMI与子宫癌风险之间存在显著的剂量-反应关系（每单位BMI增加的校正优势比=1.03,95%可信区间=1.01-1.06），且随着时间的推移，这种关系会增强。亚组分析显示，肥胖个体、非西班牙裔白人和年龄≥50岁的女性的相关性更强。结论：高BMI导致了美国子宫癌负担的上升和不平等，强调了针对肥胖和健康不平等的干预措施的迫切需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.00

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.