The global burden, trends and cross-country inequalities of female breast and gynaecologic cancers: A population based study

Objective: To analyse the global burden, trends and cross-country inequalities of female breast and gynaecologic cancers (FeBGCs). Design: Population-Based Study. Setting: Data sourced from the Global Burden of Disease Study 2019. Population: Individuals diagnosed with FeBGCs. Methods: Age-standardised mortality rates (ASMRs), age-standardised Disability-Adjusted Life Years (DALYs) rates (ASDRs) and their 95% uncertainty interval (UI) described the burden. Estimated annual percentage changes (EAPCs) and their confidence interval (CI) of age-standardised rates (ASRs) illustrated trends. Social inequalities were quantified using the Slope Index of Inequality (SII) and Concentration Index. Main Outcome Measures: The main outcome measures were the burden of FeBGCs and the trends in its inequalities over time. Results: In 2019, the ASDRs per 100 000 females were as follows: breast cancer: 473.83 (95% UI: 437.30–510.51), cervical cancer: 210.64 (95% UI: 177.67–234.85), ovarian cancer: 124.68 (95% UI: 109.13–138.67) and uterine cancer: 210.64 (95% UI: 177.67–234.85). The trends per year from 1990 to 2019 were expressed as EAPCs of ASDRs and these: for Breast cancer: −0.51 (95% CI: −0.57 to −0.45); Cervical cancer: −0.95 (95% CI: −0.99 to −0.89); Ovarian cancer: −0.08 (95% CI: −0.12 to −0.04); and Uterine cancer: −0.84 (95% CI: −0.93 to −0.75). In the Social Inequalities Analysis (1990–2019) the SII changed from 689.26 to 607.08 for Breast, from −226.66 to −239.92 for cervical, from 222.45 to 228.83 for ovarian and from 74.61 to 103.58 for uterine cancer. The concentration index values ranged from 0.2 to 0.4. Conclusions: The burden of FeBGCs worldwide showed a downward trend from 1990 to 2019. Countries or regions with higher Socio-demographic Index (SDI) bear a higher DALYs burden of breast, ovarian and uterine cancers, while those with lower SDI bear a heavier burden of cervical cancer. These inequalities increased over time.