{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:07:35Z","timestamp":1793210855094,"version":"4.5.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shanghai Xuhui District Medical Peak Discipline Construction Project","award":["SHXHZDXK202314"],"award-info":[{"award-number":["SHXHZDXK202314"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer remains a leading cause of morbidity and mortality among women, disproportionately affecting low- and middle-income countries (LMICs). We sought to: (1) characterize temporal and geographic patterns of cervical cancer burden (1990\u20132021), with a focus on age-related differences; (2) identify attributable risk factors for cervical cancer, emphasizing the impact of HPV vaccination; (3) forecast cervical cancer burden through 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We combined: (a) age-specific female population estimates (UN World Population Prospects 2024), (b) cervical cancer incidence, mortality and disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) 2021, and (c) HPV vaccination coverage (WHO). We calculated age-standardized incidence (ASIR), mortality (ASMR), and DALYs rate (ASDR) using the WHO world standard population. Stratified analyses were performed by Socio-demographic Index (SDI) category and 5-year age groups. Future burdens were projected under current intervention coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>From 1990 to 2021, global ASIR, ASMR and ASDR declined by 15, 31 and 32%, respectively, yet absolute cases rose due to population growth and ageing. The greatest burdens remain in low-SDI regions, especially Southern Sub-Saharan Africa, which uniquely saw rising ASIR and ASMR. Women aged 55\u201359 bear the highest rates, while young women (15\u201339) experienced a small but significant incidence increase in 92 countries (notably Russia, Brazil and China). Unsafe sex and smoking accounted for the majority of cervical cancer DALYs. A profound disparity in HPV vaccine coverage persists between high- and low-SDI regions. Projections to 2050 indicate a continued rise in absolute case numbers, despite modest declines in age-standardized rates (ASRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While ASRs show improvement, the growing absolute burden and profound geographic inequities highlight an urgent public health challenge. Accelerating the scale-up of HPV vaccination, screening, and other preventive measures, with a strategic focus on LMICs, is critical to achieving the WHO elimination targets for cervical cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1702186","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:19:40Z","timestamp":1769411980000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Global trends and future projections of cervical cancer burden: an integrated analysis of GBD 2021, UN population and WHO HPV vaccination data"],"prefix":"10.3389","volume":"14","author":[{"given":"Dongxuan","family":"Shao","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Shanghai Eighth People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Shanghai Eighth People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huici","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Shanghai Eighth People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/s0140-6736(18)32470-x","article-title":"Cervical cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1001\/jama.2023.13174","article-title":"Cervical cancer screening: a review","volume":"330","author":"Perkins","year":"2023","journal-title":"JAMA"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.1016\/s2214-109x(22)00501-0","article-title":"Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO global cervical Cancer elimination initiative","volume":"11","author":"Singh","year":"2023","journal-title":"Lancet Glob 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