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Cross-country inequalities and frontier analysis in global burden of cervical cancer: cross-sectional studies
Chenlu Fan1,2, Chuanxi Fu1,3
1The Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Objective:
This research evaluated global health disparities of cervical cancer, and forecasted trends from 2022 to 2040.
Methods:
Cross-country inequalities [Slope Index of Inequality (SII) and the Concentration Index] are used to measure inequality. Frontier analysis evaluates the medical quality by calculating the difference between actual values and frontier values. Average annual percentage changes (AAPCs) were computed to discern trends from 2022 to 2040.
Results:
The global SII for the age-standardized death rate (ASDR) of cervical cancer was -9.14 per 100,000 in 1990 and -9.62 in 2021. For age-standardized disability-adjusted life years (DALY) rate, the Concentration Index was -0.22 in 1990 and -0.30 in 2021. Frontier analysis calculated the difference between the actual value and the frontier value, indicating that countries with the most significant potential for reducing the disease burden of cervical cancer are Kiribati, Lesotho, Zimbabwe, Eswatini, and Eritrea. The global age standardized incidence rate (ASIR) and ASDR for cervical cancer are expected to decline by 2040, with an AAPC of -0.34 (95% confidence interval [CI]=-0.35 to -0.34) and -0.99 (95% CI=-0.99 to -0.99), respectively. However, in Eastern Europe, Central Latin America, Tropical Latin America, and Sub-Saharan Africa, the ASIR for cervical cancer is projected to continue rising through 2040. Unsafe sex is a contributing factor to cervical cancer deaths.
Conclusion:
Cross-national inequalities show that from 1990 to 2021, the trend of cervical cancer inequality has intensified and is concentrated in low socio-demographic index regions. Healthcare services in countries like Kiribati, Lesotho, and Zimbabwe need significant improvement.
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