Segmented Regression of Projected Global Age-Standardized Incidence Rates for Breast, Cervical, and Colorectal Cancers Using GBD 2023 Forecasts

Segmented Regression of Projected Global Age-Standardized Incidence Rates for Breast, Cervical, and Colorectal Cancers Using GBD 2023 Forecasts | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Segmented Regression of Projected Global Age-Standardized Incidence Rates for Breast, Cervical, and Colorectal Cancers Using GBD 2023 Forecasts Fola Atunde, Adewunmi Akingbola, Abiodun Adegbesan, Jude Ossai, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9379614/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Cancer continues to be a significant global health challenge, with an estimated 18.5 million new cancer cases in 2023, projected to increase to 30.5 million by 2050. This increase is largely driven by population growth and aging rather than worsening underlying risks. Breast, cervical, and colorectal cancers serve as key indicators of trends in cancer burden due to their relationship with prevention, screening, and vaccination. Methods Using the Global Burden of Disease 2023 (GBD 2023) cancer forecasts, we applied segmented regression analysis to project global age-standardized incidence rates (ASIR) for breast, cervical, and colorectal cancers from 2024 to 2050. Linear models were fitted to the natural log of the ASIR to estimate trends and annual percent change (APC) in incidence over time. Results For breast cancer, the ASIR is expected to decline slightly by 1.3% from 2024 to 2050, with a near-flat trend followed by modest declines. Colorectal cancer incidence is projected to decrease by 2.6%, with an early rise followed by a sharper decline after 2041. Cervical cancer is projected to show the steepest decline, decreasing by 13.3% over the study period. Conclusion While global age-standardized incidence rates for breast and colorectal cancers show modest declines, the absolute burden of cancer cases will still rise due to population aging. Continued investment in prevention, screening, and early detection remains critical to managing future cancer burden. Cancer Global Burden of Disease Segmented Regression Age-Standardized Incidence Breast Cancer Colorectal Cancer Figures Figure 1 Figure 2 Figure 3 1. Introduction Cancer remains a major global health challenge. GLOBOCAN 2022 estimated nearly 20 million new cancer cases and 9.7 million cancer deaths worldwide, and the burden is expected to continue increasing over coming decades.[ 1 ] In the GBD 2023 cancer analysis, global incident cases were estimated at 18.5 million in 2023 and forecast to rise to 30.5 million by 2050.[ 2 ] Interpreting this increase requires distinguishing absolute case counts from age-standardized rates. The same GBD 2023 analysis projected only a slight global decline in the all-cancer age-standardized incidence rate between 2024 and 2050, implying that much of the future growth in cases is driven by population ageing and population growth rather than uniform worsening of underlying risk.[ 2 ] Breast, cervical, and colorectal cancers are useful tracers of this pattern because they are common cancers of major public health importance and are closely linked to prevention, screening, or vaccination policies.[ 1 , 6 – 9 ] The Global Burden of Disease study provides annual estimates by location, age, sex, and cause, and now includes forecasted cancer burden to 2050.[ 2 , 3 ] The present study used GBD 2023 forecast estimates to describe projected global age-standardized incidence-rate trajectories for breast, cervical, and colorectal cancers from 2024 to 2050. Rather than treating modeled breakpoints as causal or observed epidemiologic turning points, we used segmented regression to summarize changes in slope within the forecast series. By fitting explicit piecewise-linear models and reporting annual percent change for each segment, this approach adds a structured quantitative description of trajectory shape that complements the graphical forecasts presented in the source GBD publication. 2. Methodology We conducted a descriptive segmented regression analysis of projected cancer incidence over 2024–2050 using the Global Burden of Disease Study 2023 Cancer Forecasts 2024–2050 dataset.[ 3 ] The forecast values are model-based estimates produced within the GBD forecasting framework, which incorporates forecasted risk-factor exposures and socio-demographic covariates.[ 2 , 5 ] Data were extracted at the global level with measure = incidence, metric = rate, and age = age-standardized. Cancer-specific series were handled separately: cervical cancer was analyzed among females only; breast cancer was analyzed among females only (male breast cancer was not included); and colorectal cancer was analyzed for both sexes combined. Each series used the corresponding global age-standardized incidence rate extracted from the GBD 2023 Cancer Forecasts dataset. Rates were expressed per 100,000 population. To model proportional change over time, we fit models to the natural log of the annual incidence rate (dividing the reported rate by 100,000 to express it as a proportion before log transformation). We then fit three-segment models using the R package segmented.[ 4 ] Two breakpoints were prespecified for each cancer to provide comparable descriptive summaries across the three forecast series; we note that alternative breakpoint structures (e.g., one or zero breakpoints) might fit some series, particularly the near-flat breast cancer trajectory—similarly well, but the three-segment specification was retained for consistency. Accordingly, the estimated joinpoints should be interpreted as modeled changes in slope within forecast point estimates, not as observed turning points in registry data. For each cancer, we summarized the approximate age-standardized incidence rate (ASIR) in 2024 and 2050, the relative change over the period, the estimated breakpoints, and the annual percent change (APC) for each segment. Figures show annual GBD forecast points and the fitted segmented lines on the log scale. Because the analysis was performed on point forecasts, the segmented APCs summarize fitted trend only and do not propagate the full GBD forecast uncertainty intervals.[ 2 , 5 ] 3. Results Table 1 summarizes the projected trajectories and modeled slope changes for the three cancers. Table 1. Summary of projected global ASIR trajectories, 2024-2050. Cancer ASIR 2024 ASIR 2050 Change Joinpoints Segment APCs (%/yr) Breast cancer 25.50 25.18 -1.3% 2025, 2037 2024-2025: +0.03 2025-2037: -0.08 2037-2050: -0.03 Colorectal cancer 25.05 24.39 -2.6% 2030, 2041 2024-2030: +0.06 2030-2041: -0.16 2041-2050: -0.19 Cervical cancer 9.81 8.50 -13.3% 2032, 2044 2024-2032: -0.62 2032-2044: -0.52 2044-2050: -0.50 Note: ASIR = age-standardized incidence rate; APC = annual percent change. Values for 2024 and 2050 are rounded descriptive values from the annual forecast series shown in the figures. APCs summarize segmented models fit to forecast point estimates. Breast cancer The projected breast cancer ASIR changed only modestly over the study period, declining by about 1.3% between 2024 and 2050 (Table 1). The segmented model identified estimated breakpoints around 2025 and 2037, dividing the series into an initial near-flat segment, a modest decline through 2037, and a continued but shallower decline thereafter. The overall pattern is therefore best described as near stability with a slight net decline rather than a marked fall (Figure 1). Colorectal cancer Projected colorectal cancer incidence showed a shallow increase early in the forecast horizon followed by a sustained decline. ASIR changed from approximately 25.05 per 100,000 in 2024 to 24.39 per 100,000 in 2050, corresponding to an overall decrease of about 2.6% (Table 1). Estimated breakpoints around 2030 and 2041 divide the series into an early growth phase, a middle declining phase, and a later steeper decline. Because the final APC is more negative than the middle-segment APC, the post-2041 pattern represents acceleration of decline rather than slowing (Figure 2). Cervical cancer Cervical cancer showed the clearest downward trajectory. ASIR declined from approximately 9.81 per 100,000 in 2024 to 8.50 per 100,000 in 2050, a reduction of about 13.3% (Table 1). Estimated breakpoints around 2032 and 2044 suggest a faster early decline followed by more modest declines thereafter, although visually the series remains close to linear on the log scale. Among the three cancers studied, cervical cancer therefore had the steepest projected proportional decrease (Figure 3). 4. Discussion This study used GBD 2023 forecast estimates to describe projected global ASIR trajectories for breast, cervical, and colorectal cancers through 2050. The results do not represent observed post-2023 registry trends; they summarize changes in slope within modeled forecast series. Interpreted in that way, three broad patterns emerged: a near-flat to slightly declining breast cancer trajectory, an early rise followed by decline for colorectal cancer, and the steepest decline for cervical cancer. The cervical cancer pattern is epidemiologically plausible given the combined effects of HPV vaccination and screening, both of which have been associated with lower invasive cervical cancer incidence in population-based studies.[ 7 – 9 ] Even so, the present analysis does not identify which intervention generated the projected slope changes; it only shows that the forecasted global cervical cancer ASIR declines over time. For colorectal cancer, the modeled trajectory suggests that any early increase is eventually outweighed by decline later in the forecast horizon. This is broadly consistent with the expectation that organized screening and early detection can reduce future burden, but the global aggregate obscures important regional heterogeneity in screening coverage, diet, obesity, and population ageing.[ 1 , 6 ] Consequently, the colorectal findings should be read as a global summary rather than evidence that all regions will experience the same pattern. The breast cancer series changed least over time, with only a small net fall in age-standardized incidence. That pattern should not be confused with the absolute number of future cases. As shown in the GBD 2023 cancer analysis, cancer counts can continue to rise even when age-standardized rates are stable or declining because demographic growth and ageing shift more people into cancer-prone age groups.[ 2 ] This distinction is important for service planning: a modest decline in rate does not eliminate the need for expanded diagnostic, treatment, and survivorship capacity. Overall, the three forecasted trajectories support continued investment in prevention and early detection, but they should be interpreted as descriptive summaries of modeled point forecasts rather than causal evidence about intervention effect sizes. 5. Limitations Several limitations should be considered. First, the analysis uses GBD forecast estimates rather than observed post-2023 incidence data. Consequently, the breakpoints represent modeled slope changes within predicted series. Second, we fit prespecified three-segment models for comparability across cancers; alternative breakpoint structures might fit some series similarly well, and the near-flat breast cancer trajectory in particular may not require two breakpoints. No formal model-selection criterion (e.g., BIC or Davies test) was applied to evaluate the number of breakpoints. Third, APCs were derived from point estimates only and do not incorporate the full GBD forecast uncertainty intervals. Fourth, the analysis is global and therefore masks potentially important regional differences in age structure, screening uptake, vaccination coverage, and risk-factor exposure. Finally, the rounded start and end ASIRs in Table 1 are presented for descriptive clarity and should be interpreted as approximate values. 6. Recommendations Future analyses should extend this work by stratifying forecasts by sex, age, region, and socio-demographic level; testing alternative breakpoint structures (including information criteria such as BIC or the Davies test to guide model selection); and propagating GBD uncertainty intervals through segmented models to produce credible intervals around segment-specific APCs. Methodologically, comparing segmented regression results with those from Joinpoint or Bayesian changepoint models would help assess the robustness of identified slope changes. From a policy perspective, the results support continued expansion of HPV vaccination and cervical screening, particularly in low- and middle-income settings where coverage remains low, organized colorectal cancer screening with timely diagnostic follow-up, and equitable breast cancer early-detection and treatment pathways that account for the growing absolute case burden even under stable age-standardized rates. 7. Conclusion Using GBD 2023 forecast estimates, global age-standardized incidence was projected to decline slightly for breast cancer, decline more clearly for colorectal cancer after 2030, and fall most strongly for cervical cancer by 2050. These patterns suggest modest improvement in underlying global rates, but they do not imply a falling absolute case burden. As populations grow and age, the number of people needing cancer prevention, screening, diagnosis, and treatment is still likely to increase. The central policy challenge is therefore to translate favorable rate trajectories into equitable reductions in future cases and deaths. Declarations ETHICAL APPROVAL AND CONSENT TO PARTICIPATE Ethical approval and consent to participate was not needed. CONSENT FOR PUBLICATION Not needed ACKNOWLEDGEMENTS No acknowledgements. FUNDING STATEMENT. No funding was gotten for this research project. DECLARATION OF INTERESTS All authors declare no competing interest. AUTHORS CONTRIBUTION STATEMENT Adewunmi Akingbola conceptualized the study, did the statistical analysis, wrote the Methodology and Results sections, Abiodun Adegbesan wrote the Abstract and edited the manuscript, Fola Atunde wrote the Discussion section, Nelson Onuoha wrote the Introduction, Jude Ossai wrote the Conclusion and Recommendations, Petra Mariaria and Arturo Loaiza-Bonilla edited the manuscript. All authors agreed to the manuscript. DATA AVAILABILITY: Data was gotten from: Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2023 (GBD 2023) Cancer Forecasts 2024-2050. Seattle, United States of America: Institute for Health Metrics and Evaluation (IHME), 2025. DOI: https://doi.org/10.6069/QZN6-GM87 References Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10.3322/caac.21834. GBD 2023 Cancer Collaborators. The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10512):1565-1586. doi:10.1016/S0140-6736(25)01635-6. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2023 (GBD 2023) Cancer Forecasts 2024-2050. Seattle (WA): Institute for Health Metrics and Evaluation; 2025. Muggeo VMR. Segmented: an R package to fit regression models with broken-line relationships. R News. 2008;8(1):20-25. GBD 2021 Forecasting Collaborators. Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2204-2256. doi:10.1016/S0140-6736(24)00685-8. Shaukat A, Levin TR. Current and future colorectal cancer screening strategies. Nat Rev Gastroenterol Hepatol. 2022;19:521-531. doi:10.1038/s41575-022-00612-y. Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023;11(2):e197-e206. doi:10.1016/S2214-109X(22)00501-0. Falcaro M, Castanon A, Ndlela B, Checchi M, Soldan K, Lopez-Bernal J, Elliss-Brookes L, Sasieni P. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study. Lancet. 2021;398(10316):2084-2092. doi:10.1016/S0140-6736(21)02178-4. Lei J, Ploner A, Elfstrom KM, Wang J, Roth A, Fang F, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340-1348. doi:10.1056/NEJMoa1917338. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 17 May, 2026 Reviewers agreed at journal 19 Apr, 2026 Reviewers invited by journal 16 Apr, 2026 Editor assigned by journal 16 Apr, 2026 Submission checks completed at journal 13 Apr, 2026 First submitted to journal 10 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9379614","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":629118605,"identity":"fb4da715-7afc-48b7-8d62-b43f900a26ef","order_by":0,"name":"Fola Atunde","email":"","orcid":"","institution":"Sinai Hospital of Baltimore","correspondingAuthor":false,"prefix":"","firstName":"Fola","middleName":"","lastName":"Atunde","suffix":""},{"id":629118606,"identity":"3cdee0c4-d100-489e-bdd4-06159b13ec52","order_by":1,"name":"Adewunmi Akingbola","email":"data:image/png;base64,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","orcid":"","institution":"University of Cambridge Old Schools Trinity","correspondingAuthor":true,"prefix":"","firstName":"Adewunmi","middleName":"","lastName":"Akingbola","suffix":""},{"id":629118608,"identity":"8a295a15-cd16-4f67-aa96-1d419ffc04a3","order_by":2,"name":"Abiodun Adegbesan","email":"","orcid":"","institution":"University of Tasmania","correspondingAuthor":false,"prefix":"","firstName":"Abiodun","middleName":"","lastName":"Adegbesan","suffix":""},{"id":629118611,"identity":"f4345102-1e55-4a2b-9c7f-6e0453642071","order_by":3,"name":"Jude Ossai","email":"","orcid":"","institution":"Newark Beth Israel Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Jude","middleName":"","lastName":"Ossai","suffix":""},{"id":629118612,"identity":"48543948-2976-474c-9f38-322706301e6e","order_by":4,"name":"Nelson Onuoha","email":"","orcid":"","institution":"Hoares Memorial Methodist Church Hospital","correspondingAuthor":false,"prefix":"","firstName":"Nelson","middleName":"","lastName":"Onuoha","suffix":""},{"id":629118615,"identity":"45468e92-0131-4d2e-b641-f6b295e2eaa4","order_by":5,"name":"Petra Mariaria","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Petra","middleName":"","lastName":"Mariaria","suffix":""},{"id":629118619,"identity":"b33439c5-d863-4c84-bfc7-6f52feceff53","order_by":6,"name":"Arturo Loaiza-Bonilla","email":"","orcid":"","institution":"St. Luke's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Arturo","middleName":"","lastName":"Loaiza-Bonilla","suffix":""}],"badges":[],"createdAt":"2026-04-10 12:39:03","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9379614/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9379614/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107864985,"identity":"a12f0d4d-40f1-4abc-9a5b-bedf8a2a5c2d","added_by":"auto","created_at":"2026-04-27 06:29:19","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":88773,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eSegmented regression of projected global breast cancer incidence, 2024-2050. Black points show annual GBD 2023 forecast estimates; the red line shows the fitted three-segment model. The y-axis is the natural log of the ASIR.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9379614/v1/d04a398ad4521fc48e9bbd94.png"},{"id":107864986,"identity":"f0f189aa-2517-4da2-9fde-700c0af79a59","added_by":"auto","created_at":"2026-04-27 06:29:19","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":92184,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eSegmented regression of projected global colorectal cancer incidence, 2024-2050. Black points show annual GBD 2023 forecast estimates; the red line shows the fitted three-segment model. The y-axis is the natural log of the ASIR.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9379614/v1/f44e6830c40dc5f19c6d2e78.png"},{"id":107870586,"identity":"a5e9ef9f-066b-4815-ab93-adf4dd7781e0","added_by":"auto","created_at":"2026-04-27 07:39:58","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":84935,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eSegmented regression of projected global cervical cancer incidence, 2024-2050. Black points show annual GBD 2023 forecast estimates; the red line shows the fitted three-segment model. The y-axis is the natural log of the ASIR.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-9379614/v1/3cab25fd877925881611c2df.png"},{"id":108006061,"identity":"4b0319f3-0157-4fee-8a67-ea0397febdea","added_by":"auto","created_at":"2026-04-28 12:52:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":369767,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9379614/v1/08e8ae86-1923-493b-a13d-8ae071aa956b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Segmented Regression of Projected Global Age-Standardized Incidence Rates for Breast, Cervical, and Colorectal Cancers Using GBD 2023 Forecasts","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eCancer remains a major global health challenge. GLOBOCAN 2022 estimated nearly 20\u0026nbsp;million new cancer cases and 9.7\u0026nbsp;million cancer deaths worldwide, and the burden is expected to continue increasing over coming decades.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] In the GBD 2023 cancer analysis, global incident cases were estimated at 18.5\u0026nbsp;million in 2023 and forecast to rise to 30.5\u0026nbsp;million by 2050.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eInterpreting this increase requires distinguishing absolute case counts from age-standardized rates. The same GBD 2023 analysis projected only a slight global decline in the all-cancer age-standardized incidence rate between 2024 and 2050, implying that much of the future growth in cases is driven by population ageing and population growth rather than uniform worsening of underlying risk.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] Breast, cervical, and colorectal cancers are useful tracers of this pattern because they are common cancers of major public health importance and are closely linked to prevention, screening, or vaccination policies.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe Global Burden of Disease study provides annual estimates by location, age, sex, and cause, and now includes forecasted cancer burden to 2050.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] The present study used GBD 2023 forecast estimates to describe projected global age-standardized incidence-rate trajectories for breast, cervical, and colorectal cancers from 2024 to 2050. Rather than treating modeled breakpoints as causal or observed epidemiologic turning points, we used segmented regression to summarize changes in slope within the forecast series. By fitting explicit piecewise-linear models and reporting annual percent change for each segment, this approach adds a structured quantitative description of trajectory shape that complements the graphical forecasts presented in the source GBD publication.\u003c/p\u003e"},{"header":"2. Methodology","content":"\u003cp\u003eWe conducted a descriptive segmented regression analysis of projected cancer incidence over 2024\u0026ndash;2050 using the Global Burden of Disease Study 2023 Cancer Forecasts 2024\u0026ndash;2050 dataset.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] The forecast values are model-based estimates produced within the GBD forecasting framework, which incorporates forecasted risk-factor exposures and socio-demographic covariates.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Data were extracted at the global level with measure\u0026thinsp;=\u0026thinsp;incidence, metric\u0026thinsp;=\u0026thinsp;rate, and age\u0026thinsp;=\u0026thinsp;age-standardized. Cancer-specific series were handled separately: cervical cancer was analyzed among females only; breast cancer was analyzed among females only (male breast cancer was not included); and colorectal cancer was analyzed for both sexes combined. Each series used the corresponding global age-standardized incidence rate extracted from the GBD 2023 Cancer Forecasts dataset. Rates were expressed per 100,000 population.\u003c/p\u003e \u003cp\u003eTo model proportional change over time, we fit models to the natural log of the annual incidence rate (dividing the reported rate by 100,000 to express it as a proportion before log transformation). We then fit three-segment models using the R package segmented.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] Two breakpoints were prespecified for each cancer to provide comparable descriptive summaries across the three forecast series; we note that alternative breakpoint structures (e.g., one or zero breakpoints) might fit some series, particularly the near-flat breast cancer trajectory\u0026mdash;similarly well, but the three-segment specification was retained for consistency. Accordingly, the estimated joinpoints should be interpreted as modeled changes in slope within forecast point estimates, not as observed turning points in registry data.\u003c/p\u003e \u003cp\u003eFor each cancer, we summarized the approximate age-standardized incidence rate (ASIR) in 2024 and 2050, the relative change over the period, the estimated breakpoints, and the annual percent change (APC) for each segment. Figures show annual GBD forecast points and the fitted segmented lines on the log scale. Because the analysis was performed on point forecasts, the segmented APCs summarize fitted trend only and do not propagate the full GBD forecast uncertainty intervals.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eTable 1 summarizes the projected trajectories and modeled slope changes for the three cancers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 1. Summary of projected global ASIR trajectories, 2024-2050.\u003c/em\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCancer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eASIR 2024\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eASIR 2050\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChange\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJoinpoints\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSegment APCs (%/yr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003eBreast cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e25.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e25.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e-1.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e2025,\u003cbr\u003e\u0026nbsp;2037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e2024-2025: +0.03\u003cbr\u003e\u0026nbsp;2025-2037: -0.08\u003cbr\u003e\u0026nbsp;2037-2050: -0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003eColorectal cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e25.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e24.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e-2.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e2030,\u003cbr\u003e\u0026nbsp;2041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e2024-2030: +0.06\u003cbr\u003e\u0026nbsp;2030-2041: -0.16\u003cbr\u003e\u0026nbsp;2041-2050: -0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003eCervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e9.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e8.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e-13.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e2032,\u003cbr\u003e\u0026nbsp;2044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e2024-2032: -0.62\u003cbr\u003e\u0026nbsp;2032-2044: -0.52\u003cbr\u003e\u0026nbsp;2044-2050: -0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eNote: ASIR = age-standardized incidence rate; APC = annual percent change. Values for 2024 and 2050 are rounded descriptive values from the annual forecast series shown in the figures. APCs summarize segmented models fit to forecast point estimates.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBreast cancer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe projected breast cancer ASIR changed only modestly over the study period, declining by about 1.3% between 2024 and 2050 (Table 1). The segmented model identified estimated breakpoints around 2025 and 2037, dividing the series into an initial near-flat segment, a modest decline through 2037, and a continued but shallower decline thereafter. The overall pattern is therefore best described as near stability with a slight net decline rather than a marked fall (Figure 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eColorectal cancer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProjected colorectal cancer incidence showed a shallow increase early in the forecast horizon followed by a sustained decline. ASIR changed from approximately 25.05 per 100,000 in 2024 to 24.39 per 100,000 in 2050, corresponding to an overall decrease of about 2.6% (Table 1). Estimated breakpoints around 2030 and 2041 divide the series into an early growth phase, a middle declining phase, and a later steeper decline. Because the final APC is more negative than the middle-segment APC, the post-2041 pattern represents acceleration of decline rather than slowing (Figure 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCervical cancer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCervical cancer showed the clearest downward trajectory. ASIR declined from approximately 9.81 per 100,000 in 2024 to 8.50 per 100,000 in 2050, a reduction of about 13.3% (Table 1). Estimated breakpoints around 2032 and 2044 suggest a faster early decline followed by more modest declines thereafter, although visually the series remains close to linear on the log scale. Among the three cancers studied, cervical cancer therefore had the steepest projected proportional decrease (Figure 3).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study used GBD 2023 forecast estimates to describe projected global ASIR trajectories for breast, cervical, and colorectal cancers through 2050. The results do not represent observed post-2023 registry trends; they summarize changes in slope within modeled forecast series. Interpreted in that way, three broad patterns emerged: a near-flat to slightly declining breast cancer trajectory, an early rise followed by decline for colorectal cancer, and the steepest decline for cervical cancer.\u003c/p\u003e \u003cp\u003eThe cervical cancer pattern is epidemiologically plausible given the combined effects of HPV vaccination and screening, both of which have been associated with lower invasive cervical cancer incidence in population-based studies.[\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] Even so, the present analysis does not identify which intervention generated the projected slope changes; it only shows that the forecasted global cervical cancer ASIR declines over time.\u003c/p\u003e \u003cp\u003eFor colorectal cancer, the modeled trajectory suggests that any early increase is eventually outweighed by decline later in the forecast horizon. This is broadly consistent with the expectation that organized screening and early detection can reduce future burden, but the global aggregate obscures important regional heterogeneity in screening coverage, diet, obesity, and population ageing.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] Consequently, the colorectal findings should be read as a global summary rather than evidence that all regions will experience the same pattern.\u003c/p\u003e \u003cp\u003eThe breast cancer series changed least over time, with only a small net fall in age-standardized incidence. That pattern should not be confused with the absolute number of future cases. As shown in the GBD 2023 cancer analysis, cancer counts can continue to rise even when age-standardized rates are stable or declining because demographic growth and ageing shift more people into cancer-prone age groups.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] This distinction is important for service planning: a modest decline in rate does not eliminate the need for expanded diagnostic, treatment, and survivorship capacity.\u003c/p\u003e \u003cp\u003eOverall, the three forecasted trajectories support continued investment in prevention and early detection, but they should be interpreted as descriptive summaries of modeled point forecasts rather than causal evidence about intervention effect sizes.\u003c/p\u003e"},{"header":"5. Limitations","content":"\u003cp\u003eSeveral limitations should be considered. First, the analysis uses GBD forecast estimates rather than observed post-2023 incidence data. Consequently, the breakpoints represent modeled slope changes within predicted series. Second, we fit prespecified three-segment models for comparability across cancers; alternative breakpoint structures might fit some series similarly well, and the near-flat breast cancer trajectory in particular may not require two breakpoints. No formal model-selection criterion (e.g., BIC or Davies test) was applied to evaluate the number of breakpoints. Third, APCs were derived from point estimates only and do not incorporate the full GBD forecast uncertainty intervals. Fourth, the analysis is global and therefore masks potentially important regional differences in age structure, screening uptake, vaccination coverage, and risk-factor exposure. Finally, the rounded start and end ASIRs in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e are presented for descriptive clarity and should be interpreted as approximate values.\u003c/p\u003e"},{"header":"6. Recommendations","content":"\u003cp\u003eFuture analyses should extend this work by stratifying forecasts by sex, age, region, and socio-demographic level; testing alternative breakpoint structures (including information criteria such as BIC or the Davies test to guide model selection); and propagating GBD uncertainty intervals through segmented models to produce credible intervals around segment-specific APCs. Methodologically, comparing segmented regression results with those from Joinpoint or Bayesian changepoint models would help assess the robustness of identified slope changes. From a policy perspective, the results support continued expansion of HPV vaccination and cervical screening, particularly in low- and middle-income settings where coverage remains low, organized colorectal cancer screening with timely diagnostic follow-up, and equitable breast cancer early-detection and treatment pathways that account for the growing absolute case burden even under stable age-standardized rates.\u003c/p\u003e"},{"header":"7. Conclusion","content":"\u003cp\u003eUsing GBD 2023 forecast estimates, global age-standardized incidence was projected to decline slightly for breast cancer, decline more clearly for colorectal cancer after 2030, and fall most strongly for cervical cancer by 2050. These patterns suggest modest improvement in underlying global rates, but they do not imply a falling absolute case burden. As populations grow and age, the number of people needing cancer prevention, screening, diagnosis, and treatment is still likely to increase. The central policy challenge is therefore to translate favorable rate trajectories into equitable reductions in future cases and deaths.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eETHICAL APPROVAL AND CONSENT TO PARTICIPATE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval and consent to participate was not needed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot needed\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo acknowledgements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING STATEMENT.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was gotten for this research project.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDECLARATION OF INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare no competing interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHORS CONTRIBUTION STATEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdewunmi Akingbola conceptualized the study, did the statistical analysis, wrote the Methodology and Results sections, Abiodun Adegbesan wrote the Abstract and edited the manuscript, Fola Atunde wrote the Discussion section, Nelson Onuoha wrote the Introduction, Jude Ossai wrote the Conclusion and Recommendations, Petra Mariaria and Arturo Loaiza-Bonilla edited the manuscript. All authors agreed to the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDATA AVAILABILITY:\u003c/strong\u003e Data was gotten from: Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2023 (GBD 2023) Cancer Forecasts 2024-2050. Seattle, United States of America: Institute for Health Metrics and Evaluation (IHME), 2025.\u003c/p\u003e\n\u003cp\u003eDOI: https://doi.org/10.6069/QZN6-GM87 \u0026nbsp;\u003cbr clear=\"all\"\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10.3322/caac.21834.\u003c/li\u003e\n\u003cli\u003eGBD 2023 Cancer Collaborators. The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10512):1565-1586. doi:10.1016/S0140-6736(25)01635-6.\u003c/li\u003e\n\u003cli\u003eGlobal Burden of Disease Collaborative Network. Global Burden of Disease Study 2023 (GBD 2023) Cancer Forecasts 2024-2050. Seattle (WA): Institute for Health Metrics and Evaluation; 2025.\u003c/li\u003e\n\u003cli\u003eMuggeo VMR. Segmented: an R package to fit regression models with broken-line relationships. R News. 2008;8(1):20-25.\u003c/li\u003e\n\u003cli\u003eGBD 2021 Forecasting Collaborators. Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2204-2256. doi:10.1016/S0140-6736(24)00685-8.\u003c/li\u003e\n\u003cli\u003eShaukat A, Levin TR. Current and future colorectal cancer screening strategies. Nat Rev Gastroenterol Hepatol. 2022;19:521-531. doi:10.1038/s41575-022-00612-y.\u003c/li\u003e\n\u003cli\u003eSingh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023;11(2):e197-e206. doi:10.1016/S2214-109X(22)00501-0.\u003c/li\u003e\n\u003cli\u003eFalcaro M, Castanon A, Ndlela B, Checchi M, Soldan K, Lopez-Bernal J, Elliss-Brookes L, Sasieni P. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study. Lancet. 2021;398(10316):2084-2092. doi:10.1016/S0140-6736(21)02178-4.\u003c/li\u003e\n\u003cli\u003eLei J, Ploner A, Elfstrom KM, Wang J, Roth A, Fang F, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340-1348. doi:10.1056/NEJMoa1917338.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bulletin-of-the-national-research-centre","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnrc","sideBox":"Learn more about [Bulletin of the National Research Centre](https://BNRC.springeropen.com)","snPcode":"42269","submissionUrl":"https://submission.springernature.com/new-submission/42269/3","title":"Bulletin of the National Research Centre","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cancer, Global Burden of Disease, Segmented Regression, Age-Standardized Incidence, Breast Cancer, Colorectal Cancer","lastPublishedDoi":"10.21203/rs.3.rs-9379614/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9379614/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCancer continues to be a significant global health challenge, with an estimated 18.5\u0026nbsp;million new cancer cases in 2023, projected to increase to 30.5\u0026nbsp;million by 2050. This increase is largely driven by population growth and aging rather than worsening underlying risks. Breast, cervical, and colorectal cancers serve as key indicators of trends in cancer burden due to their relationship with prevention, screening, and vaccination.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eUsing the Global Burden of Disease 2023 (GBD 2023) cancer forecasts, we applied segmented regression analysis to project global age-standardized incidence rates (ASIR) for breast, cervical, and colorectal cancers from 2024 to 2050. Linear models were fitted to the natural log of the ASIR to estimate trends and annual percent change (APC) in incidence over time.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFor breast cancer, the ASIR is expected to decline slightly by 1.3% from 2024 to 2050, with a near-flat trend followed by modest declines. Colorectal cancer incidence is projected to decrease by 2.6%, with an early rise followed by a sharper decline after 2041. Cervical cancer is projected to show the steepest decline, decreasing by 13.3% over the study period.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWhile global age-standardized incidence rates for breast and colorectal cancers show modest declines, the absolute burden of cancer cases will still rise due to population aging. Continued investment in prevention, screening, and early detection remains critical to managing future cancer burden.\u003c/p\u003e","manuscriptTitle":"Segmented Regression of Projected Global Age-Standardized Incidence Rates for Breast, Cervical, and Colorectal Cancers Using GBD 2023 Forecasts","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-27 06:29:15","doi":"10.21203/rs.3.rs-9379614/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"147889290136840530957992179600846934399","date":"2026-05-18T00:19:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"93495432666014692527794330356176106515","date":"2026-04-19T06:56:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-16T23:57:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-16T14:10:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-13T04:48:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"Bulletin of the National Research Centre","date":"2026-04-10T12:28:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bulletin-of-the-national-research-centre","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnrc","sideBox":"Learn more about [Bulletin of the National Research Centre](https://BNRC.springeropen.com)","snPcode":"42269","submissionUrl":"https://submission.springernature.com/new-submission/42269/3","title":"Bulletin of the National Research Centre","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"465f5069-9ea8-486c-b4cc-b02a5292c1a4","owner":[],"postedDate":"April 27th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"147889290136840530957992179600846934399","date":"2026-05-18T00:19:43+00:00","index":49,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-27T06:29:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-27 06:29:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9379614","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9379614","identity":"rs-9379614","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}