Comparative analysis of cervical cancer burden trends between China and G20 countries from 1990 to 2023 with projections to 2035: A population-based observational study.

This study aimed to systematically compare and analyze the trends in cervical cancer disease burden between China and G20 countries from 1990 to 2023 based on the Global Burden of Disease (GBD) 2023 database and project the trajectory through 2035, thereby providing scientific evidence for optimizing cervical cancer prevention and control strategies. Data were sourced from the GBD 2023 database. Age-standardized incidence rate, mortality rate, and disability-adjusted life years (DALYs) rate of cervical cancer among females in China and G20 countries were selected as study indicators. The estimated annual percentage change (EAPC) was used to assess temporal trends in disease burden; decomposition analysis was employed to quantify the contributions of population growth, aging, and epidemiological changes; frontier analysis was conducted based on the socio-demographic index (SDI); and a Bayesian age-period-cohort model was applied to project mortality in 2035. From 1990 to 2023, the age-standardized incidence rate of cervical cancer in China declined from 17.32 per 100,000 to 12.06 per 100,000 (EAPC: -1.04), with a 52.4% reduction in mortality rate, significantly outperforming the 31.8% reduction observed in G20 countries. China's DALYs rate decreased from 294.14 per 100,000 to 133.06 per 100,000 (EAPC: -2.43). Substantial heterogeneity was observed among G20 member states, with South Africa recording the highest incidence rate (47.54 per 100,000) and Italy exhibiting an anomalous increase in mortality. Both China and G20 countries showed peak cervical cancer burden in the 50 to 54 age group. Decomposition analysis revealed that epidemiological improvements in China (-128.58%) successfully offset the combined effects of aging (+91.35%) and population growth (+137.22%), whereas G20 countries achieved only partial counterbalancing. Frontier analysis indicated that China's actual DALYs rate approached the theoretical optimum corresponding to its SDI level. Projections suggest that cervical cancer deaths in China will decline by 40.9% from 2023 to 2035, compared to only 7.9% in G20 countries. China has achieved remarkable progress in cervical cancer prevention and control, with epidemiological improvements effectively offsetting the adverse impacts of demographic factors. Nevertheless, continued efforts to strengthen human papillomavirus vaccination and screening coverage remain essential to achieve the strategic goal of cervical cancer elimination.