Abstract
BackgroundThe increasing aging population has been posing a significant challenge to disease burden in developing countries. In particular, the contribution of population aging to and long term changes of disease burden of malignant neoplasm of female genital organs (MNFGO) have not been quantitatively demonstrated.MethodsData were collected from the Shanghai Vital Statistics System of Pudong New Area (PNA). Crude mortality rate (CMR), age-standardized mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) of MNFGO as the underlying cause of death in age and pathology types from 1995 to 2018 were calculated. The joinpoint regression was used to estimate the trends of those rates by identifying the annual percent changes (APCs), and the decomposition method was used to calculate the increased rates and the contribution resulting from demographic and non-demographic factors.ResultsFrom 1995 to 2018, a total of 2869 MNFGO-specific deaths were reported in PNA, accounting for 0.64% of the total deaths. The CMR and ASMRW of MNFGO were 9.23/105 person-years and 4.80/105 person-years, respectively. Ovary cancer was the most common cause of MNFGO death, accounting for 43.9% (1260/2869) of all MNFGO death. Other common causes of MNFGO death included cervix uteri cancer, uterus unspecified cancer, and corpus uteri cancer. With the increase of age, the mortality rate of MNFGO in residents had shown an upward trend ([APC (95%CI) = 3.46 (2.74, 4.18), P < 0.001)] for each five-year age group from 0 to 4 to 85+ years. From 1995 to 2018, YLL of MNFGO in Shanghai PNA was 42,152.82 years, and the rate of YLL was 135.56 /105. The top three MNFGO types in YLLs were ovary cancer, cervix uteri cancer and uterus unspecified cancer. Demographic factors contributed significantly to the upward trends of CMR, ASMRW, and YLL rates of MNFGO.ConclusionWith aggravated population aging in Shanghai, MNFGO is and will continue to be a serious threat to women’s health. More precise and effective prevention strategies are needed to target high risk population, to achieve efficient health resource allocation and to improve women’s health in particular.
Highlights
The increasing aging population has been posing a significant challenge to disease burden in developing countries
With the increase of age, the mortality rate of malignant neoplasm of female genital organs (MNFGO) in residents had shown an upward trend ([annual percent change (APC) (95%95% confidence interval (CI)) = 3.46 (2.74, 4.18), P < 0.001)] for each five-year age group from 0 to 4 to 85+ years
**P < 0.001 95% CI 95% confidence interval, APC Annual percent change, ASMRW Age-standardized mortality rate by Segi’s world standard population, CMR Crude mortality rate, MNFGO Malignant neoplasm of female genital organs, PNA Pudong New Area, years of life lost (YLL) Years of life lost in Table 4 and Fig. 1d-e
Summary
The increasing aging population has been posing a significant challenge to disease burden in developing countries. The morbidity and mortality of gynecological malignancies are on the rise [1] This increased health burden may be partially attributed to demographic changes such as aging, as well as lifestyle changes associated with rapid economic development [2]. PNA has been oriented as a national economic and technological development zone since early 1990s, consisting of a mixture of urban, suburban, and rural geographic areas [4]. It is a typical sample of China’s reformation and urbanization. It is the microcosm of China’s reformation and a good representative of Shanghai [5]
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