Table 1 Burden of combined gynecological diseases (CGDs) among women of childbearing age in 2021 and their average percentage changes from 1990 to 2021 at the global and regional levels
Characteristics | DALYs (95% CI) | Death (95% CI) | Incidence (95% CI) | Prevalence (95% CI) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Count | ASDR (per 100,000 population) | AAPC for ASDR (%) | P-value | Count | ASMR (per 100,000 population) | AAPC for ASMR (%) | P-value | Count | ASIR (per 100,000 population) | AAPC for ASIR (%) | P-value | Count | ASPR (per 100,000 population) | AAPC for ASPR (%) | P-value | |
Global | 45,218,531.35 (31,315,646.01–64911062.18) | 2280.68 (1577.01–3278.47) | 0.28 (0.19 to 0.36) |  < 0.001 | 385,713.81 (310,300.91–483,620.37) | 19.3 (15.51–24.22) | 0.53 (0.25 to 0.82) |  < 0.001 | 899,068,453.31 (611,860,823.87–1,232,400,408.47) | 45,690.02 (31,094.86–62,601.32) | 0 (− 0.02 to 0.02) | 0.849 | 2,170,136,352.21 (1,564,197,137.89–2,913,885,604.92) | 109,937.36 (79,173.46–147,739.67) | 0.08 (0.06 to 0.1) |  < 0.001 |
Age group (years) | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
15–19 | 2,250,171.59 (1,436,090.38–3,480,124.99) | 741.04 (472.94–1146.1) | 0.52 (0.42 to 0.61) |  < 0.001 | 14,274.23 (10,275.99–19,152.4) | 4.7 (3.38–6.31) | 1.2 (0.89 to 1.52) |  < 0.001 | 69,099,273.87 (43,516,689.89–97,723,279.28) | 22,756.23 (14,331.2–32,182.87) | 0.01 (− 0.01 to 0.03) | 0.203 | 150,366,384.34 (105,876,194.62–211,456,574.76) | 49,519.64 (34,867.84–69,638.27) | 0.06 (0.05 to 0.08) |  < 0.001 |
20–24 | 4,326,617.14 (2,840,789.37–6,542,927.4) | 1472.88 (967.07–2227.36) | 0.21 (0.07 to 0.34) | 0.002 | 27,630.55 (21,118.04–35984.06) | 9.41 (7.19–12.25) | 0.32 (− 0.26 to 0.89) | 0.281 | 105,234,104.72 (73,445,639.99–140,171,224.61) | 35,824.13 (25,002.6–47,717.53) | 0.13 (0.11 to 0.16) |  < 0.001 | 246,092,908.39 (171,369,722.5–332,465,053.82) | 83,775.73 (58,338.23–113,178.81) | 0.25 (0.24 to 0.27) |  < 0.001 |
25–29 | 6,597,050.7 (4,359,341.24–9,809,073.28) | 2267.13 (1498.12–3370.96) | 0.12 (− 0.1 to 0.35) | 0.268 | 44,444.99 (33,934.77–58,249.06) | 15.27 (11.66–20.02) | 0.25 (− 0.28 to 0.78) | 0.362 | 145,094,161.15 (99,436,606.34–199,314,020.42) | 49,862.72 (34,172.15–68,495.79) | 0.08 (0.02 to 0.14) | 0.007 | 313,619,092.96 (224,768,552.82–429,325,332.63) | 107,777.6 (77,243.43–147,540.93) | 0.17 (0.16 to 0.18) |  < 0.001 |
30–34 | 8,370,434.09 (5,769,371.57–11,923,658.25) | 2800.12 (1930–3988.77) | 0.3 (0.04 to 0.56) | 0.025 | 63,838.84 (50,167.44–81,390.64) | 21.36 (16.78–27.23) | 0.68 (0.38 to 0.98) |  < 0.001 | 174,689,165.28 (125,180,319.74–231,452,331.13) | 58,437.98 (41,876.01–77426.71) | 0.01 (− 0.03 to 0.04) | 0.676 | 379,850,007.46 (266,986,996.03–525614475.27) | 127,069.51 (89,313.96–175,831.45) | 0.07 (0.05 to 0.1) |  < 0.001 |
35–39 | 8,615,690.61 (6,085,003.27–12,192,294.64) | 3101.37 (2190.4–4388.83) | 0.51 (0.33 to 0.69) |  < 0.001 | 71,620.24 (58,685.44–89,111.2) | 25.78 (21.12–32.08) | 1.08 (0.59 to 1.58) |  < 0.001 | 171,726,382.4 (116,118,654.14–230,737,885.63) | 61,815.94 (41,798.96–83,058.18) | 0 (− 0.02 to 0.01) | 0.576 | 413,172,476.07 (299,257,436.62–551,708,844.34) | 148,728.73 (107,723–198597.34) | 0.07 (0.04 to 0.11) |  < 0.001 |
40–44 | 8,129,470.94 (5,780,579.29–11,396,064.44) | 3276.83 (2330.03–4593.52) | 0.4 (0.25 to 0.54) |  < 0.001 | 80,079.8 (66,788.4–95,370.08) | 32.28 (26.92–38.44) | 0.75 (0.45 to 1.06) |  < 0.001 | 137,754,776.18 (93,930,621.77–189,083,792.73) | 55,526.16 (37,861.53–76,215.85) | − 0.07 (− 0.1 to − 0.04) |  < 0.001 | 378,506,880.6 (276,185,538.05–495340839.15) | 152,568.46 (111,324.8–199,661.86) | 0.03 (0.02 to 0.05) |  < 0.001 |
45–49 | 6,929,096.29 (5,044,470.9–9,566,919.19) | 2940.51 (2140.73–4059.93) | − 0.07 (− 0.12 to − 0.01) | 0.025 | 83,825.15 (69,330.84–104,362.94) | 35.57 (29.42–44.29) | 0.02 (− 0.16 to 0.2) | 0.846 | 95,470,589.71 (60,232,292–143917874.66) | 40,515 (25,560.87–61,074.65) | − 0.22 (− 0.28 to − 0.16) |  < 0.001 | 288,528,602.4 (219,752,697.25–367,974,484.94) | 122,443.32 (93,256.79–156,157.89) | -0.1 (-0.11 to -0.09) |  < 0.001 |
Socio-demographic index | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
High SDI | 3,400,377.04 (2,125,400.56–5,239,395.27) | 1304.84 (806.64–2027.67) | − 0.44 (− 0.54 to − 0.34) |  < 0.001 | 10,245.34 (9795.94–10,716.84) | 3.54 (3.38–3.7) | − 2 (− 2.11 to − 1.89) |  < 0.001 | 100,675,641.66 (67,567,891.53–140,495,159.03) | 39,916.14 (26,792.84–55,619.06) | − 0.04 (− 0.07 to − 0.02) |  < 0.001 | 256,974,323.16 (182,941,017.34–348,912,628.87) | 100,274.97 (71,147.26–136,663.45) | 0 (-0.02 to 0.02) | 0.918 |
High-middle SDI | 5,024,101.42 (3,283,940.19–7,538,314.14) | 1491.65 (963.22–2262.36) | − 0.12 (− 0.22 to − 0.01) | 0.034 | 26,426.15 (23,645.77–30,003.61) | 7.19 (6.44–8.16) | 0.14 (− 0.14 to 0.42) | 0.32 | 136,305,720.5 (91,873,799.35–189,488,971.87) | 42,585.68 (28,698.11–59,128.32) | − 0.2 (− 0.24 to − 0.16) |  < 0.001 | 335,086,121.82 (236,162,461.49–458,842,178.38) | 102,868.5 (72,166.86–141,421.41) | -0.07 (-0.09 to -0.06) |  < 0.001 |
Middle SDI | 12,956,237.56 (9,327,570.27–18,097,545.78) | 2014.03 (1445.99–2822.94) | 0.72 (0.46 to 0.98) |  < 0.001 | 103,229.67 (91,927.2–115,809.35) | 15.73 (14.01–17.66) | 1.66 (1.24 to 2.08) |  < 0.001 | 281,655,731.62 (190,949,160.13–389,184,350.22) | 44,565.13 (30,201.05–61512.42) | − 0.1 (− 0.21 to 0) | 0.052 | 693,863,497.59 (498,965,267.75–934,896,753.18) | 109,074.61 (78,258.1–147,227.05) | 0.07 (0.05 to 0.09) |  < 0.001 |
Low-middle SDI | 13,151,292.13 (8,743,110.34–19,251,559.74) | 2673.86 (1785.08–3902.72) | 0.41 (0.22 to 0.6) |  < 0.001 | 126,855.92 (92,391.67–171,251) | 26.23 (19.19–35.31) | 0.89 (0.49 to 1.28) |  < 0.001 | 231,047,085.72 (157,169,099.95–316,234,957.23) | 46,192.24 (31,395.81–63,298.86) | 0.04 (0.02 to 0.06) | 0.001 | 559,799,991.53 (402,788,112.31–751,419,968.94) | 112,650.6 (81,206.32–150,935.99) | 0.09 (0.08 to 0.1) |  < 0.001 |
Low SDI | 10,651,764.35 (7,341,209.58–15,256,560.26) | 4309.35 (2976.45–6162.53) | − 1.26 (− 1.72 to − 0.8) |  < 0.001 | 118,640.82 (85,532.49–164,509.73) | 49.54 (35.71–68.85) | − 1.71 (− 2.37 to − 1.04) |  < 0.001 | 148,645,224.91 (101,778,909.34–202,178,534.34) | 57,770.87 (39,512.94–78,726.34) | 0.01 (− 0.01 to 0.03) | 0.226 | 322,718,686.03 (238,316,626.41–422,988,455.14) | 127,041.23 (94,254.24–165,561.91) | 0.01 (-0.01 to 0.03) | 0.432 |
Region | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
Andean Latin America | 337,502.69 (214,609.92–515,104.65) | 1926.77 (1225.74–2940.26) | − 0.17 (− 0.34 to 0.01) | 0.061 | 2051.48 (1576.78–2703.03) | 11.84 (9.09–15.61) | − 0.61 (− 1.41 to 0.19) | 0.133 | 8,927,722.36 (5,998,537.14–12,396,606.29) | 50,768.04 (34,069.29–70,543.95) | 0 (− 0.03 to 0.03) | 0.9 | 23,706,471.05 (17,556,784.32–31,251,295.52) | 135,206.6 (100,133.64–178,220.73) | 0.05 (0.02 to 0.07) |  < 0.001 |
Australasia | 98,368.5 (57,424.33–158,233.63) | 1289.13 (748.11–2085.39) | − 0.49 (− 0.6 to − 0.38) |  < 0.001 | 196.87 (161.26–239.14) | 2.37 (1.94–2.88) | − 2.77 (− 3.58 to − 1.95) |  < 0.001 | 2,816,971.11 (1,858,714.35–3,979,023.9) | 37,821.02 (24,942.83–53,438.01) | − 0.11 (− 0.13 to − 0.09) |  < 0.001 | 7,189,951.29 (5,140,752.37–9,720,935.94) | 95,791.04 (68,279.72–129,876.7) | -0.21 (-0.24 to -0.18) |  < 0.001 |
Caribbean | 355,191.04 (220,855.18–546,964.5) | 2907.82 (1804.71–4483.03) | − 0.64 (− 1.05 to − 0.23) | 0.002 | 3983.69 (2600.38–5926.73) | 32.43 (21.12–48.3) | − 0.91 (− 1.52 to − 0.29) | 0.004 | 6,247,324.93 (4,148,830.17–8,736,784.65) | 51,540.17 (34,232.69–72,045.36) | − 0.01 (− 0.02 to 0) | 0.006 | 15,135,169.24 (11,043,304.01–20001195) | 124,576.98 (90,839.54–164,737.54) | -0.02 (-0.02 to -0.01) |  < 0.001 |
Central Asia | 366,791.63 (235,461.62–555,599.78) | 1456.64 (933.83–2210.54) | − 0.16 (− 0.25 to − 0.06) | 0.001 | 1877.56 (1644.2–2144.75) | 7.45 (6.52–8.51) | − 0.46 (− 0.88 to − 0.05) | 0.028 | 13,722,610.63 (9,223,995.94–19,257,560.05) | 55,127.44 (36,978.26–77,426.89) | − 0.04 (− 0.06 to − 0.01) | 0.003 | 26,388,168.03 (18,721,001.21–35,945,389.3) | 105,985.43 (75,152.35–144,290.65) | 0 (-0.01 to 0.01) | 0.952 |
Central Europe | 311,253.03 (201,474.03–470764.54) | 1085.31 (687.15–1669.69) | − 0.78 (− 0.87 to − 0.7) |  < 0.001 | 1834.86 (1626.89–2055.16) | 5.43 (4.81–6.07) | − 2.17 (− 2.42 to − 1.93) |  < 0.001 | 9,631,347.32 (6,417,973.2–13,578,875.24) | 36,577.31 (24,433.57–51,374.03) | − 0.14 (− 0.17 to − 0.12) |  < 0.001 | 23,532,650.79 (16,434,475.64–32,502,739.08) | 86,287.91 (59,810.32–119,881.01) | -0.05 (-0.07 to -0.03) |  < 0.001 |
Central Latin America | 1,101,660.88 (743,886.26–1,630,749.53) | 1597.28 (1077.37–2367.16) | − 0.41 (− 0.51 to − 0.31) |  < 0.001 | 7935.48 (6999.91–8907.97) | 11.4 (10.06–12.8) | − 0.73 (− 0.85 to − 0.62) |  < 0.001 | 36,025,432.68 (24,022,314.14–50,716,171.38) | 52,561.24 (35,053.44–73,932.57) | − 0.12 (− 0.17 to − 0.07) |  < 0.001 | 85,621,819.59 (63,000,352.57–112,980,253.2) | 124,588.54 (91,610.41–164,518.95) | -0.04 (-0.06 to -0.01) | 0.003 |
Central Sub-Saharan Africa | 1,710,397.81 (1,086,121.17–2,554,730.87) | 5933.85 (3809.54–8771.11) | − 0.7 (− 1.26 to − 0.14) | 0.014 | 21,241.14 (13,534.7–31,455.12) | 76.2 (49.13–111.61) | − 0.85 (− 1.42 to − 0.29) | 0.003 | 18,485,195.1 (12,755,561.03–24956819.73) | 60,800.48 (41,939.97–82,000.75) | − 0.02 (− 0.03 to − 0.01) | 0.001 | 46,618,649.93 (35,002,612.73–60,304,671.45) | 154,947.14 (117,015.14–198,973.52) | 0.01 (-0.01 to 0.03) | 0.185 |
East Asia | 4,256,516.56 (2,482,516.15–6,854,585.55) | 1168.13 (675.55–1896.64) | − 0.57 (− 0.62 to − 0.52) |  < 0.001 | 18,965.47 (13,544.72–25,385.95) | 4.61 (3.29–6.15) | − 0.7 (− 0.92 to − 0.48) |  < 0.001 | 131,561,347.19 (87,298,889.56–187,114,024.63) | 37,966.8 (25,144.05–53866.55) | − 0.35 (− 0.59 to − 0.11) | 0.005 | 328,184,010.63 (224,603,821.6–462,536,467.61) | 93,067.85 (63,444.11–131,468.74) | -0.14 (-0.24 to -0.05) | 0.004 |
Eastern Europe | 1,344,909.48 (1,000,022.45–1,839,022.38) | 2409.28 (1771.71–3333.28) | 1.06 (0.81 to 1.31) |  < 0.001 | 11,924.13 (11,308.98–12,617.2) | 20.08 (19.1–21.19) | 2.68 (2.1 to 3.27) |  < 0.001 | 26,984,105.81 (17,988,009.41–37,707,743.14) | 51,988.93 (34,636.32–72,769.26) | − 0.04 (− 0.05 to − 0.02) |  < 0.001 | 65,664,937.65 (46,789,694.21–89,000,419.04) | 123,892.14 (87,627.42–168,952.64) | 0.02 (0.01 to 0.02) |  < 0.001 |
Eastern Sub-Saharan Africa | 7,547,053.35 (5,209,540.39–10,880,262.43) | 7872.97 (5422.79–11,380.32) | − 1.33 (− 2.02 to − 0.64) |  < 0.001 | 99,892.9 (68,787.38–145,154.94) | 107.51 (73.63–157.16) | − 1.56 (− 2.32 to − 0.79) |  < 0.001 | 67,054,438.81 (45,731,840.36–91,522,394.72) | 67,333.97 (45,759.6–92,204.74) | − 0.06 (− 0.07 to − 0.04) |  < 0.001 | 139,424,998.71 (104,858,490.86–179,216,322.48) | 141,609.02 (106,998.48–180,851.36) | -0.01 (-0.03 to 0.01) | 0.26 |
High-income Asia Pacific | 416,123.63 (254,672.35–663,628.65) | 1010.29 (603.56–1636.58) | − 0.34 (− 0.4 to − 0.28) |  < 0.001 | 1688.08 (1552.03–1862.22) | 3.25 (2.98–3.6) | − 0.81 (− 1.32 to − 0.29) | 0.002 | 10,359,889.39 (6,560,918.56–15,264,097.17) | 27,215.12 (17,290.59–39,736.33) | − 0.23 (− 0.3 to − 0.16) |  < 0.001 | 35,460,204.17 (24,931,674.2–49,010,507.82) | 88,201.09 (61,713.84–122,395.13) | -0.2 (-0.24 to -0.16) |  < 0.001 |
High-income North America | 938,892.94 (593,809.64–1,452,503.99) | 1069.04 (670.65–1664.49) | − 0.74 (− 1 to − 0.48) |  < 0.001 | 3836.62 (3674.67–4011.36) | 4.1 (3.93–4.29) | − 2.22 (− 2.49 to − 1.95) |  < 0.001 | 30,279,372.57 (19,457,880.28–44,457,371.63) | 35,181.54 (22,623.17–51,496.06) | − 0.1 (− 0.19 to − 0.02) | 0.02 | 83,905,805.23 (59,927,064.43–113,797,067.85) | 96,557.74 (68,768.9–131,353.39) | 0.08 (0.02 to 0.15) | 0.013 |
North Africa and Middle East | 3,365,101.26 (2,047,002.96–5,229,679.4) | 2083.06 (1266.26–3240.13) | 0.04 (0.02 to 0.07) |  < 0.001 | 7932.35 (5423.48–12,913.07) | 4.93 (3.37–8.03) | 0.83 (0.71 to 0.96) |  < 0.001 | 105,837,364.47 (74,857,008.29–139,161,875.05) | 65,641.97 (46,370.96–86,423.63) | − 0.06 (− 0.08 to − 0.03) |  < 0.001 | 204,515,531.42 (148,997,935.22–270,705,412.16) | 126,885.27 (92,394.35–168,067.83) | 0 (-0.01 to 0.01) | 0.846 |
Oceania | 73,106.02 (41,769.87–122,420.6) | 2197.17 (1259.71–3674.31) | 0.65 (0.24 to 1.06) | 0.002 | 659.91 (376.66–1137.91) | 20.48 (11.73–35.27) | 1.21 (0.53 to 1.89) |  < 0.001 | 2,235,713.31 (1,529,104.23–3,093,203.5) | 64,622.84 (44,098.85–89,620.59) | − 0.08 (− 0.17 to 0.01) | 0.079 | 3,894,477.02 (2,884,041.31–5,075,172.89) | 113,973.85 (84,472.74–148,378.98) | 0.01 (-0.01 to 0.03) | 0.361 |
South Asia | 7,791,463.05 (4,769,507.33–12,348,549.26) | 1608.22 (988.26–2541.52) | − 0.19 (− 0.37 to − 0.02) | 0.033 | 46,168.57 (33,492.04–66245.16) | 9.8 (7.14–13.99) | − 0.31 (− 0.67 to 0.05) | 0.092 | 188,772,840.52 (125,339,076.03–264177436.77) | 38,390.95 (25,456.48–53,804.12) | − 0.05 (− 0.1 to − 0.01) | 0.017 | 511,280,826.58 (356,655,734.21–703,268,393.04) | 104,579.16 (73,064.77–143,647.93) | 0.06 (0.05 to 0.08) |  < 0.001 |
Southeast Asia | 2,639,739.2 (1,694,076.59–4,024,105.32) | 1407.64 (901.26–2150.53) | − 0.07 (− 0.2 to 0.06) | 0.266 | 19,064.23 (14,862.55–24,049.23) | 9.94 (7.75–12.54) | − 0.12 (− 0.35 to 0.11) | 0.289 | 64,093,479.46 (42,388,515.03–90247603.54) | 34,682.01 (22,940.29–48,781.74) | − 0.12 (− 0.15 to − 0.09) |  < 0.001 | 182,982,291.37 (129,666,488.17–248,802,215.24) | 98,490.58 (69,706.07–134077.53) | 0.05 (0.02 to 0.07) |  < 0.001 |
Southern Latin America | 308,923.82 (203,294.12–459,491.19) | 1703.18 (1117.36–2540) | − 0.16 (− 0.32 to 0) | 0.046 | 1920.46 (1674.63–2207.27) | 10.34 (9.02–11.88) | − 0.5 (− 0.86 to − 0.14) | 0.007 | 7,202,150.63 (4,711,728.31–10,192,071.89) | 40,452.97 (26,477.93–57,228.65) | − 0.01 (− 0.02 to 0) | 0.012 | 20,254,016.59 (14,521,458.83–27,382,483.06) | 112,965.12 (80,853.5–152,992.06) | -0.04 (-0.06 to -0.03) |  < 0.001 |
Southern Sub-Saharan Africa | 3,999,401.08 (3,334,706.18–4,911,511.09) | 18,363.82 (15,293.01–22580.62) | 2.67 (1.73 to 3.62) |  < 0.001 | 56,189.27 (47,335.79–68,941.77) | 259.4 (218.15–318.88) | 3.04 (1.96 to 4.14) |  < 0.001 | 18,778,266.98 (12,956,669.58–25,409,180.46) | 85,937.98 (59,243.64–116,538.74) | − 0.18 (− 0.22 to − 0.14) |  < 0.001 | 39,391,163.04 (30,939,387.82–49,210,251.24) | 181,440.51 (142,664.6–226,325.06) | 0.33 (0.31 to 0.36) |  < 0.001 |
Tropical Latin America | 1,062,580.24 (761,867.07–1500363.65) | 1666.43 (1188.13–2364.65) | − 0.04 (− 0.21 to 0.13) | 0.612 | 8300.24 (7904.55–8718.72) | 12.6 (12.01–13.24) | − 0.03 (− 0.22 to 0.17) | 0.801 | 31,546,155.02 (21,346,663.31–44,116,537.11) | 50,772.06 (34,354.4–70,895.65) | − 0.09 (− 0.14 to − 0.04) |  < 0.001 | 76,163,488.91 (56,917,825.91–99,071,480.58) | 121,056.88 (90,243.89–157,803.43) | -0.07 (-0.09 to -0.05) |  < 0.001 |
Western Europe | 1,633,913.9 (1,001,677.1–2,543,520.37) | 1639.73 (996.35–2571.32) | − 0.48 (− 0.53 to − 0.43) |  < 0.001 | 3249.33 (3054.94–3459.07) | 2.83 (2.66–3.01) | − 2.52 (− 2.92 to − 2.12) |  < 0.001 | 44,111,765.43 (29,621,725.69–60,564,926.17) | 45,686.89 (30,750.19–62,709.29) | − 0.23 (− 0.25 to − 0.2) |  < 0.001 | 105,258,962.37 (73,420,023.76–144,067,139.47) | 107,025.83 (74,492.49–147,041.07) | -0.13 (-0.15 to -0.1) |  < 0.001 |
Western Sub-Saharan Africa | 5,559,641.24 (3,687,543.7–8,125,169.2) | 5348.22 (3588.05–7733.92) | 0.53 (0.13 to 0.93) | 0.01 | 66,801.18 (45,519.39–95,420.3) | 66.67 (45.94–94.22) | 0.91 (0.33 to 1.49) | 0.002 | 74,394,959.6 (50,740,737.18–101,638,066.12) | 67,788.77 (46,209.95–92,661.58) | 0.01 (− 0.01 to 0.03) | 0.252 | 145,562,758.62 (107,092,617.56–191,157,366.3) | 134,113.49 (99,258.63–174,833.53) | 0 (-0.01 to 0.01) | 0.998 |