Global trends, risk factors, and future projections of ovarian cancer burden among women aged 50 years and older: a systematic analysis based on GBD 2021
Background:
Ovarian cancer (OC) remains one of the most lethal gynecological malignancies worldwide, with a disproportionate burden in older women. This study aims to quantify and project the OC burden from 1990 to 2021 using data from the Global Burden of Disease Study 2021 (GBD 2021).
Methods:
Leveraging data from the GBD 2021, this study comprehensively assessed trends in OC-related disability-adjusted life years (DALYs), deaths, incidence, and prevalence across 204 countries and 21 regions from 1990 to 2021, and age-standardized rates were calculated. Joinpoint regression and age-period-cohort (APC) modeling were used to identify temporal trends and cohort effects. Inequality was assessed using the Slope Index of Inequality (SII) and Concentration Index (CI). The Bayesian age-period-cohort (BAPC) model was applied to project OC burden through 2050.
Results:
From 1990 to 2021, absolute DALYs, deaths, incidence, and prevalence of OC among women ≥50 years increased markedly, while ASRs declined globally. High and high-middle SDI regions exhibited the highest burden, particularly among women under 75 years. Australasia demonstrated sustained improvement, whereas Andean Latin America experienced worsening trends. Health inequality, reflected in declining SII and CI values, has narrowed since 1990. High BMI emerged as the dominant risk factor, especially in Central Europe. Occupational asbestos exposure remained regionally significant, particularly in Australasia. Projections indicate continued increases in OC burden through 2050, driven by demographic aging and rising life expectancy.
Conclusion:
Despite improvements in age-standardized OC metrics, the absolute burden continues to rise globally, underscoring the need for age- and region-specific strategies.