Global, regional, and national quality of care index of cervical and ovarian cancer - a systematic analysis for the global burden of disease study 1990–2019

Sep 21, 2026

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Cervical cancer is the most preventable and ovarian cancer the most lethal gynecological malignancy, yet international disparities in health-care performance create differences in disease burden. This study compares health-system quality of care and inequities for both cancers using the Quality of Care Index (QCI). Analyses use 1990–2019 Global Burden of Disease data and derive four quality proxy indices from incidence, prevalence, mortality, DALYs, YLL, and YLD. Principal Components Analysis constructs an overall QCI summary.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background and objective

Material and methods

Results

Conclusions

Background

Burden and trends of cervical and ovarian cancer

Disparities in care performance and drivers

Azangou‑Khyavy et al. BMC Women’s Health (2024) 24:69 BMC Women’s Health [https://doi.org/10.1](https://doi.org/10.1) 186/s12905‑024‑02884‑9 RESEARCH Open Access Global, regional, and national quality of care index of cervical and ovarian cancer: a systematic analysis for the global burden of disease study 1990–2019 Mohammadreza Azangou‑Khyavy1,2† , Erfan Ghasemi1†, Negar Rezaei1 , Javad Khanali 1,2 , Ali‑Asghar Kolahi2 , Mohammad‑Reza Malekpour 1 , Mahsa Heidari‐Foroozan1,3 , Maryam Nasserinejad 1, Esmaeil Mohammadi 1 , Mohsen Abbasi‑Kangevari1,2 , Seyyed‑Hadi Ghamari 1,2 , Narges Ebrahimi 1, Sogol Koolaji 1, Mina Khosravifar 1, Sahar Mohammadi Fateh 1, Bagher Larijani4 and Farshad Farzadfar 1,4* Abstract Background and objective Cervical cancer is the most preventable and ovarian cancer is the most lethal gyneco‑ logical cancer. However, in the world, there are disparities in health care performances resulting in differences in the burden of these cancers. The objective of this study was to compare the health‑system quality of care and ineq‑ uities for these cancers using the Quality of Care Index (QCI) . Material and methods The 1990–2019 data of the Global Burden of Disease (GBD) was analyzed to extract rates of incidence, prevalence, mortality, Disability‑Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years of healthy life lost due to disability (YLD) of cervical and ovarian cancer. Four indices were developed as a proxy for the quality of care using the above‑mentioned rates. Thereafter, a Principal Components Analysis (PCA) was applied to construct the Quality of Care Index (QCI) as a summary measure of the developed indices. Results The incidence of cervical cancer decreased from 1990 to 2019, whereas the incidence of ovarian cancer increased between these years. However, the mortality rate of both cancers decreased in this interval. The global age‑ standardized QCI for cervical cancer and ovarian cancer were 43.1 and 48.5 in 1990 and increased to 58.5 and 58.4 in 2019, respectively. QCI for cervical cancer and ovarian cancer generally decreased with aging, and different age groups had inequitable QCIs. Higher‑income countries generally had higher QCIs for both cancers, but exceptions were also observed. Conclusions Uncovering disparities in cervical and ovarian cancer care across locations, Socio‑Demographic Index levels, and age groups necessitate urgent improvements in healthcare systems for equitable care. These findings underscore the need for targeted interventions and prompt future research to explore root causes and effective strat‑ egies for narrowing these gaps. †Mohammadreza Azangou‑Khyavy and Erfan Ghasemi contributed equally asthe first author. *Correspondence: Farshad Farzadfarf‑[farzadfar@tums.ac.ir](farzadfar@tums.ac.ir) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative

FAQs

What is the study’s primary objective regarding cervical and ovarian cancer?

To compare health-system quality of care and inequities for cervical and ovarian cancer using the Quality of Care Index (QCI).

What data and indicators are used to build the Quality of Care Index?

1990–2019 Global Burden of Disease data are analyzed, including incidence, prevalence, mortality, DALYs, YLL, and YLD, which are transformed into four proxy indices for quality of care.

How does the QCI change from 1990 to 2019, and how is it affected by age and income?

Global age-standardized QCI increases from 1990 to 2019 for both cancers, while QCI generally decreases with aging and varies across age groups. Higher-income countries generally show higher QCIs, with some exceptions.

Sep 21, 2026

Uploaded by Jiven