Analyzing and forecasting global cervical cancer burden based on WHO's elimination strategy: insights and projections from a 1990–2021 global burden of disease (GBD) study covering 204 countries and territories

Introduction: Cervical cancer remains a major global public health challenge. In 2018, the WHO launched a strategy to eliminate cervical cancer, emphasizing the need for precise epidemiological assessments. Objectives: This study utilized Global Burden of Disease (GBD) data to analyze the epidemiological indicators, geographical patterns, and temporal trends of cervical cancer, evaluating the global impact of the WHO's strategy. Methods: Data on cervical cancer from 204 countries and territories (from 1990 to 2021) were retrieved from the GBD database. The year 2018, marking the WHO's global call for elimination, was used to divide data into two periods: 1990 to 2018 and 2019 to 2021. Trends in age-standardized incidence rates and disability-adjusted life years (DALYs) were assessed using estimated annual percentage changes (EAPCs) and joinpoint regression. The socio-demographic index (SDI) was regressed against epidemiological indicators to explore disparities. Health inequality analyses recommended by the WHO were conducted, and an autoregressive integrated moving average (ARIMA) model was applied to predict future trends. Results: From 1990 to 2021, global age-standardized incidence rates and DALYs declined. During 1990 to 2018, the highest EAPC values were observed in Southern Sub-Saharan Africa (2·18), East Asia (0·69), and Eastern Europe (0·31). After 2019, a more significant improvement was noted globally. Regression analyses revealed an SDI-related gradient, with low-SDI countries lagging. Health inequality analyses showed widening disparities. ARIMA projections indicated stable incidence rates in most regions but a continued decline in DALYs. Conclusion: The WHO's strategy has contributed to a notable decline in cervical cancer burden, yet challenges persist in low-SDI regions. Strengthening global cooperation and resource allocation is essential for achieving elimination goals.