Analyzing Global and Regional Cervical Cancer Burden from Unsafe Sex: 1990-2019 Trend Study

Abstract

Abstract Background Cervical cancer ranks as the fourth most common cancer among women globally, primarily attributed to unsafe sexual behavior. Yet, the disease burden stemming from this cause remains unreported. Aims This study aimed to quantitatively assess cervical cancer's burden and evolving patterns attributable to unsafe sexual practices across diverse global regions from 1990 to 2019. Our goal was to provide insights for effective strategies in primary cervical cancer prevention. Methods Leveraging data from the 2019 Global Burden of Disease database, we employed key metrics including deaths, Disability-Adjusted Life Years, and age-standardized rates to quantitatively evaluate the global impact of cervical cancer associated with unsafe sex. We utilized the Estimated Annual Percentage Change method with R3.4.3 software to comprehend cervical cancer's burden and its distribution across regions and age groups due to unsafe sexual practices. We generated comprehensive geographical and hotspot maps for analysis. Further, we applied the General Additive Model and Spearman's correlation method to explore relationships between Age-Standardized Mortality Rates, Age-Standardized Death Rates, and Socio-Demographic Index. Results Between 1990 and 2019, deaths attributed to cervical cancer related to unsafe sexual practices surged by 52.00%. However, the Age-Standardized Mortality Rate decreased by 14.45%, averaging an annual decline of 0.93%. The High Socio-Demographic Index regions showed the most substantial decrease at 36.45%, with an annual decline of 1.57%. In contrast, the Low SDI regions exhibited the highest ASMR at 15.05/100,000 but experienced the slowest decline at 21.51%. Disability-Adjusted Life Years and Age-Standardized Death Rates associated with unsafe sex displayed declining trends, reducing by 0.13% and 23.42%, respectively. Central Sub-Saharan Africa recorded the highest ASMR and ASDR at 21.67/100,000 and 678.72/100,000, respectively. Among age groups, individuals aged over 70 years had the highest ASMR, while those aged 55-59 years had the highest ASDR. Conclusions Cervical cancer's disease burden due to unsafe sexual behavior has generally decreased. However, it remains significantly severe in regions with low Human Development Index (SDI) scores, with a relatively slow rate of decline. Promoting early cervical cancer screening and implementing additional medical strategies are imperative to mitigate this burden, particularly in low SDI score countries.