Mapping the burden of uterine cancer in the EU from 1990-2021: Global and national disparities, age trends, and implications for public health.

Abstract

e17639 Background: Uterine cancer (UC), predominantly endometrial carcinoma, is a major public health concern in the European Union (EU), driven by factors like aging populations, rising obesity rates, and reproductive trends. Early detection offers favorable outcomes, disparities in healthcare access and screening contribute to varying survival rates across member states. Methods: Using the GBD 2021 standardized tool, we estimated the incidence, prevalence, deaths, and disability-adjusted life years (DALYs) associated with UC across the EU from 1990 to 2021, stratified by age, year, and location. Non-fatal health outcomes derived using the DISMOD-MR 2.1 model, while fatal health outcomes estimated using the Cause of Death Ensemble Model (CODEm). Results: The total prevalence of UC in the EU increased from 324,730 (306,685–339,283) in 1990 to 642,772 (591,565–680,429) in 2021, while deaths rose from 11,177 (10,388–11,773) to 16,133 (13,948–17,424), and disability-adjusted life years (DALYs) grew from 261,392 (246,893–275,225) to 347,681 (312,470–373,515). The highest annual percentage change (APC) in age-standardized incidence rate (ASIR) was observed in Italy (3.92%), followed by Poland (1.89%), Romania (1.73%), Latvia (1.53%), Lithuania (1.32%), and Greece (1.27%), while the age-standardized mortality rate (ASMR) showed the highest APC increase in Italy (2.35%), Bulgaria (0.76%), Poland (0.7%), Latvia (0.6%), Lithuania (0.5%), Greece (0.3%), and Romania (0.04%), with the remaining countries exhibiting a declining trend from 1990 to 2021. In terms of age-standardized DALYs rate (ASDALR), the highest APC increase was seen in Italy (3.68%), Poland (1.88%), Latvia (1.74%), Malta (1.65%), and Bulgaria (1.61%). The highest incidence count in 2021 was recorded in the 65–69 age group at 14,144 (12,773–15,371), followed by the 60–64 age group at 13,654 (12,384–14,856), while the highest number of deaths occurred in the 70–74 age group at 2,538 (2,286–2,736), followed by the 80–84 age group at 2,488 (2,016–2,790). The DALYs burden was highest in the 65–69 age group, reaching 57,828 (52,871–62,504) in 2021. Conclusions: The burden of UC in the EU has significantly increased over the past three decades, with rising prevalence, mortality, and DALYs, particularly in aging populations. While some countries have observed declining trends in mortality, others, such as Italy, Poland, and Latvia, have experienced substantial increases in incidence and disease burden. The highest impact is seen in older age groups, emphasizing the need for targeted screening, early detection, and improved access to treatment. Addressing disparities in healthcare infrastructure and implementing effective prevention strategies, including obesity management and reproductive health awareness, will be critical in reducing the growing burden of uterine cancer across the EU.