Worldwide association of the gender inequality with the incidence and mortality of cervical, ovarian, endometrial, and breast cancers

Shahin Kavousi; Najmeh Maharlouei; Alireza Rezvani; Hossein Akbari Aliabad; Hossein Molavi Vardanjani

doi:10.1016/j.ssmph.2024.101613

Worldwide association of the gender inequality with the incidence and mortality of cervical, ovarian, endometrial, and breast cancers

SSM Popul Health. 2024 Jan 24:25:101613. doi: 10.1016/j.ssmph.2024.101613. eCollection 2024 Mar.

Authors

Shahin Kavousi¹, Najmeh Maharlouei², Alireza Rezvani³, Hossein Akbari Aliabad⁴, Hossein Molavi Vardanjani⁵

Affiliations

¹ MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
² Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Department of Internal Medicine, School of Medicine, Hematology Research Center, Stem Cells Research Institute, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Student Research Committee, School of Medicine, Shiraz University of Medical Sciences and Health Services, Shiraz, Iran.
⁵ MD-MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Background: There is a huge disparity in cancer incidence and mortality around the globe. A considerable share of this disparity can be explained by human development. Particularly in many less developed countries, women have been hindered in their human development. In this ecological study, we hypothesize that, notwithstanding acceptable overall development in countries, gender inequalities might affect the incidence and mortality of women's malignancies, and there is a distinct association between them.

Method: The data on the incidence and mortality of gynecologic and female breast cancers were retrieved from the GLOBOCAN database, and the data on the Human Development Index (HDI), Gender Development Index (GDI), and Gender Inequality Index (GII) were obtained from the United Nations Human Development Report. The Poisson regression modeling was then used to fit four models for each cancer.

Result: GII and GDI are both significantly associated with incidences of women's cancers, except for the insignificant association between GDI and the incidence of ovarian cancer. However, the association between GDI and the mortality of women's cancer is not strong. At the same time, there are significant direct relationships between GII and the mortality of breast, cervical, and endometrial cancer.

Conclusion: The incidence and mortality of women's cancers are ecologically associated with the country-level gender inequality captured with GDI and GII.

Keywords: Breast cancer; Cancer incidence; Cancer mortality; Cervical cancer; Gender development; Gender inequality; Gynecologic neoplasms.