Trends and Age-Period-Cohort Effects on Mortality of the Three Major Gynecologic Cancers in China from 1990 to 2019: Cervical, Ovarian and Uterine Cancer

Background: Gynecologic cancer seriously threatens women's life and health. This study aims to assess the long-term trends of mortality from the three major gynecologic cancers in China and to examine the age-, period-, and cohort-specific effects behind them during the period 1990 to 2019. Methods: The mortality data of cervical, ovarian, and uterine cancer in China were obtained from the Global Burden of Disease Study 2019 and were analyzed with the age–period–cohort framework. Results: It was found that the net drift for cervical cancer mortality was −0.19% (95% CI, −0.46% to 0.08%) per year, for ovarian cancer was 0.76% (95% CI, 0.57% to 0.95%) per year, and for uterine cancer was −3.09% (95% CI, −3.44% to −2.76%) per year from 1990 to 2019. During this period, while cervical cancer remained the most common cause of death among gynecologic cancers among Chinese women, ovarian cancer replaced uterine cancer as the second leading cause of death in gynecologic cancers after about 2005. Significant age, cohort, and period effects were found for the mortality trends of all three major gynecologic cancers. Conclusions: The secular trends of mortality from the three major gynecologic cancers in China and their underlying age, period, and cohort effects are likely to reflect the progress of diagnosis and treatment, rapid socio-economic transitions, and the accompanying lifestyle and behavior changes. More priorities of further epidemiology studies and efforts on the prevention and control should be given to three major gynecologic cancers. Funding Information: This study was supported by the National Natural Science Foundation of China (No. 81903396, No. 81874106, and No. 82073259). Declaration of Interests: None. Ethics Approval Statement: This study analyzed data from a nationwide population-based Chinese cohort from the GBD 2019, which did not interact with human subjects or personal identity information.