The mortalities of female-specific cancers in China and other countries with distinct socioeconomic statuses: A longitudinal study

Dongming Jiang; Zheyun Niu; Xiaojie Tan; Haiwei He; Longbing Ren; Jiaying Shen; Xiaoqiong Zhu; Pei Zhao; Mei Liu; Hongsen Chen; Ruihua Wang; Qi Li; Guangwen Cao

doi:10.1016/j.jare.2022.09.002

The mortalities of female-specific cancers in China and other countries with distinct socioeconomic statuses: A longitudinal study

J Adv Res. 2023 Jul:49:127-139. doi: 10.1016/j.jare.2022.09.002. Epub 2022 Sep 18.

Authors

Dongming Jiang¹, Zheyun Niu¹, Xiaojie Tan², Haiwei He³, Longbing Ren¹, Jiaying Shen¹, Xiaoqiong Zhu⁴, Pei Zhao⁵, Mei Liu², Hongsen Chen², Ruihua Wang⁶, Qi Li⁷, Guangwen Cao⁸

Affiliations

¹ Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine Tongji University, Shanghai 200120, China.
² Department of Epidemiology, Second Military Medical University, Shanghai 200433, China.
³ Department of Gynecology and Obstetrics, Changhai Hospital, Shanghai, 200433, China.
⁴ Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China.
⁵ Cancer Hospital, Guangxi Medical University, Nanning 530021, China.
⁶ Department of Epidemiology, Jinan University School of Medicine, Guangzhou 510632, China.
⁷ Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
⁸ Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine Tongji University, Shanghai 200120, China; Department of Epidemiology, Second Military Medical University, Shanghai 200433, China. Electronic address: gcao@smmu.edu.cn.

Abstract

Introduction: Female-specific cancers seriously affect physical and psychological health of women worldwide.

Objectives: We aimed to elucidate trends in the age-standardized mortality rates (ASMRs) of breast cancer, cervical cancer, uterine cancer, and ovarian cancer in female populations with different socioeconomic statuses in China and in countries with different Human Development Index (HDI).

Methods: A longitudinal study was performed using the data of cancer death in China and other 39 countries. The mortality rates were standardized with the Segi's world population. Trends in the mortalities were exhibited by estimated annual percentage change (EAPC). Pearson correlation was used to assess the association between EAPC and HDI.

Results: In mainland China, female breast cancer, cervical cancer, uterine cancer, and ovarian cancer accounted for 6.60 %, 4.21 %, 2.50 %, and 2.02 % of cancer death (n = 1,314,040) in women with 1,220,251,032 person-years, respectively. The ASMRs of cervical cancer (EAPC = 3.87 %, P < 0.001) and ovarian cancer (EAPC = 1.81 %, P < 0.001) increased, that of female breast cancer unchanged, whereas that of uterine cancer was extremely higher and rapidly decreased (EAPC = - 7.65 %, P < 0.001), during 2004-2019. The ASMRs of female breast and ovarian cancers were higher in urban and developed regions than in rural and undeveloped regions, in contrast to cervical and uterine cancers. The ASMRs of female breast and ovarian cancers were lower in China than in other countries, in contrast to uterine cancer. The ASMR of cervical cancer decreased, that of uterine cancer increased, in other countries during 2004-2017. EAPCs for the ASMRs of breast and ovarian cancers were inversely correlated to HDI.

Conclusion: The ASMRs of cervical and ovarian cancers increased, in contrast to uterine cancer, in China during socioeconomic transition. Trends in the ASMRs of breast and ovarian cancers were inversely associated with HDI. These data help control female-specific cancers.

Keywords: China; Developed country; Developing country; Female-specific cancer; Longitudinal study; Mortality.

MeSH terms

Breast Neoplasms* / epidemiology
China / epidemiology
Female
Humans
Longitudinal Studies
Ovarian Neoplasms*
Social Class
Uterine Cervical Neoplasms*
Uterine Neoplasms*