Global Trends and Inequities in Breast and Gynecologic Hormone-Driven Cancers: A Long-Term Epidemiologic Analysis
Keywords:
breast cancer, endometrial cancer, ovarian cancer, cervical cancer, hormone-driven cancers, global epidemiology, health inequities, HPV vaccinationAbstract
Background. Hormone-driven malignancies of the breast, endometrium, and ovary, together with cervical cancer driven by persistent human papillomavirus infection, account for the largest share of female cancer burden worldwide. Long-term trends reveal widening inequities between high-income and transitioning economies. Methods. We synthesized epidemiological data from GLOBOCAN 2022, the Global Burden of Disease Study 2021, the World Health Organization, and 50 peer-reviewed publications spanning 1990 to 2026. Age-standardized incidence rates, mortality-to-incidence ratios, and average annual percent changes were extracted to compare regional patterns and identify modifiable drivers. Results. In 2022, breast cancer accounted for 2.3 million new cases and 670,000 deaths globally. Asia recorded the highest absolute number of breast cancer cases (985,817), while Africa carried the highest mortality-to-incidence ratio (0.510). Endometrial cancer incidence rose by 0.69 percent annually between 1990 and 2019, with the steepest increases in high-income regions linked to obesity. Ovarian cancer incidence is projected to rise by 55 percent and mortality by nearly 70 percent by 2050, with the greatest increases concentrated in low- and middle-income countries. Cervical cancer remains overwhelmingly a disease of inequity, with 94 percent of deaths occurring in low- and middle-income settings despite effective preventive tools. Conclusion. Hormone-driven female cancers exhibit divergent trajectories shaped by reproductive transitions, obesity, screening access, and vaccination coverage. Equity-focused, region-tailored prevention is essential to reverse the projected doubling of global burden by 2050.
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