Zhongguo quanke yixue (May 2022)

Age-Period-Cohort Analysis of Secular Trends of Cervical Cancer Incidence and Mortality in China, 1993—2017

  • Jinyao WANG, Nianping ZHANG, Zhiqiang BAI, Zhenkun WANG

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0074
Journal volume & issue
Vol. 25, no. 13
pp. 1564 – 1568

Abstract

Read online

Background Cervical cancer is the seventh most common cancer globally, and the fourth most common cancer in women, accounting for about 12% of all cancers diagnosed among females. Cervical cancer and liver cancer are similar with respect to high prevalent region, with about 85% of the sufferers are from less developed regions. Objective To assess the long-term trends of cervical cancer incidence and mortality in China. Methods Data about cervical cancer incidence and mortality in Chinese adult females were extracted from the Institute for Health Metrics and Evaluation. Joinpoint regression was used for analyzing the trends of cervical cancer incidence and mortality during 1993—2017. The age-period-cohort model and intrinsic estimator method were adopted for analyzing the effects of age, period, and cohort on cervical cancer incidence and mortality. Results Overall, the trends of cervical cancer incidence and mortality totally experienced a significant decrease during 1993—1998, and showed an increasing trend during 2008—2015. Joinpoint regression analysis showed that from 1993 to 2017, the standardized incidence ratio of cervical cancer increased from 9.54/100 000 to 10.88/100 000〔AAPC (95%CI) =0.6 (0.3, 0.9) , P<0.05〕, while its standardized mortality ratio decreased from 4.88/100 000 to 4.48/100 000〔AAPC (95%CI) =-0.3 (-0.5, -0.1) , P<0.05〕. Moreover, cervical cancer incidence increased significantly with age before the age of 59, and the period effect exhibited a general upward trend for both incidence and mortality. The incidence and mortality risks by birth cohort showed a declining trend except for some periods and the risks all peaked in the cohort born in 1916—1920, then leveled off and slightly decreased in younger generations. Conclusion Taken together, the decrease in the cohort effect might contribute to the decrease in cervical cancer incidence and mortality rates, while the increase of age and period effects might lead to the increase in its morbidity and mortality rates.

Keywords