Female reproductive Cancers burden and projection in China: a time-trend analysis and comparison with the United States, United Kingdom and global based on the global epidemiological data released in 2020

BACKGROUND Gynecologic cancer (GC) is an important cause of human mortality. Developed countries have good ways of cancer patterns and control strategies that can inform the development of relevant policies in China to improve cancer control measures and reduce the burden caused by gynecologic cancers. This study reviewed the trends of gynecologic cancer incidence, mortality, and disability-adjusted life year (DALY) burden in China and compared them with the United States and the United Kingdom. METHODS Data on gynecologic cancer incidence, mortality, and DALY in China, the United States, the United Kingdom, and globally were obtained from the GLOBOCAN2020 online database. Trends in cancer incidence and mortality in China, the US, the UK, and globally were analyzed using Joinpoint regression models to calculate annual percentage change (APC) and determine the best-fit joinpoint. The Bayesian age-period-cohort model was used to predict the trends in age-standardized incidence and mortality rates for GC during 2021–2036. RESULTS Compared with 1990, in 2021, China had increased breast, cervical, and ovarian cancer incidence and mortality cases, and increased uterine cancer incidence but decreased mortality. Compared with the United States and the United Kingdom, China had lower ASIRs for all four gynecologic tumors, but higher ASDRs for cervical and ovarian cancers. In addition, gynecologic tumor incidence and mortality rates are increasing in all three countries and globally between 1990 and 2021, driven primarily by population growth. Age-standardized rates of incidence for the remaining three tumors, except for cervical cancer, are projected to increase in China by 2036. Conclusions GC continues to be a significant public health concern worldwide, with notable regional and demographic disparities in the burden based on menopausal status. The GC spectrum in China is shifting from a developing to a developed country. Population ageing and the increase in unhealthy lifestyles will continue to increase the GC burden in China. Therefore, the Chinese authorities should refer to the practices of cancer control in developed countries and adjust the national cancer control program.