Global burden, temporal trends and cross-national inequalities of the comorbidity between depressive disorder and hormone-dependent tumors in women of reproductive ages from 1990 to 2021: A population-based analysis with projections to 2036.

[BACKGROUND] This study aimed to analyze the global comorbidity burden of depressive disorder (DD) and hormone-dependent tumors (HDTs), including breast cancer (BC), ovarian cancer (OC), and uterine cancer (UC), among women of reproductive ages (WRAs) using Global Burden of Disease (GBD) 2021 data.

[METHODS] Long-term trends between 1990 and 2021 in the incidence, prevalence, and disability-adjusted life years (DALYs) of the comorbidity burden were used Joinpoint regression analysis. Future trends to 2036 were projected via a Bayesian age-period-cohort (BAPC) model. Age-period-cohort (APC) model to dissect temporal trends, decomposition analysis to quantify the contributions of demographic changes, and cross-country inequality and frontier analyses to evaluate socio-economic disparities and improvement potential across nations.

[RESULTS] From 1990 to 2021, the age-standardized incidence rate (ASIR) and prevalence rate (ASPR) of the comorbidity burden of DD and HDTs increased globally, while the age-standardized DALYs rate (ASDALYsR) decreased. The APC model identified women aged 45-49 years as bearing the most stable and high-risk burden. Decomposition analysis revealed that population growth and epidemiological changes were the primary drivers of the increasing burden. Cross-country inequality analysis indicated that high-SDI countries shouldered a greater comorbidity burden, yet the gap with low-SDI regions was narrowing. Frontier analysis suggested that high-SDI regions possessed the largest potential for burden reduction.

[CONCLUSIONS] The comorbidity burden of DD and HDTs among WRAs is projected to continue rising over the next 15 years. Public health efforts must prioritize high-risk age groups and high-SDI regions, integrating depression screening and management into oncologic care to mitigate this growing dual burden.