Long-term trends and future projections of cervical cancer burden in China, 1990–2023: a Global Burden of Disease 2023 analysis

OBJECTIVE: Cervical cancer remains a major public health challenge among women in China. This study aimed to comprehensively assess long-term trends and future projections of cervical cancer burden in China. METHODS: Data on cervical cancer in China from 1990 to 2023 were extracted from Global Burden of Disease Study2023. Prevalence, incidence, deaths, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and age-standardized rates (ASRs) were analyzed. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Das Gupta decomposition quantified the contributions of population growth, aging, and epidemiological change. Nordpred was used to project deaths and DALYs from 2024 to 2045. RESULTS: From 1990 to 2023, prevalent cervical cancer cases increased from 445,795 (95% uncertainty interval [UI]=301,749-642,609) to 752,306 (95% UI=481,273 to 1,011,544). YLDs increased by 62%, whereas YLLs decreased by 4%. Overall DALYs decreased slightly from 1,457,115 (95% UI=1,070,025 to 2,064,940) to 1,430,054 (95% UI=896,628 to 1,874,757), while deaths increased by 16%. Age-standardized DALYs rate (ASDR) declined from 294.14 to 132.72 per 100,000 population, with an EAPC of -2.43 (95% confidence interval=-2.54 to -2.33). Decomposition showed that population aging and growth offset favorable epidemiological changes, and projections suggested continued declines in ASDR with relatively stable deaths through 2045. CONCLUSION: Despite sustained declines in ASRs, the absolute burden of cervical cancer in China remains considerable due to demographic shifts. These findings underscore the urgent need to strengthen human papillomavirus vaccination coverage and expand equitable cervical cancer screening programs.