Disease Burden and Attributable Risk Factors of Ovarian Cancer From 1990 to 2017: Findings From the Global Burden of Disease Study 2017

Abstract

Aim: We aimed to estimate the disease burden and risk factors attributable to ovarian cancer, and epidemiological trends at global, regional, and national levels. Methods: We described ovarian cancer data on incidence, mortality, and disability-adjusted life-years as well as age-standardized rates from 1990 to 2017 from the Global Health Data Exchange database. We also estimated the risk factors attributable to ovarian cancer deaths and disability-adjusted life-years. Measures were stratified by region, country, age, and socio-demographic index. The estimated annual percentage changes and age-standardized rates were calculated to evaluate temporal trends. Results: Globally, ovarian cancer incident, death cases, and disability-adjusted life-years increased by 88.01, 84.20, and 78.00%, respectively. However, all the corresponding age-standardized rates showed downward trends with an estimated annual percentage change of -0.10 (-0.03 to 0.16), -0.33 (-0.38 to -0.27), and -0.38 (-0.32 to 0.25), respectively. South and East Asia and Western Europe carried the heaviest disease burden. The highest incidence, deaths, and disability-adjusted life-years were mainly in people aged 50-69 years from 1990 to 2017. High fasting plasma glucose level was the greatest contributor in age-standardized disability-adjusted life-years rate globally as well as in all socio-demographic index quintiles and most Global Disease Burden regions. Other important factors were high body mass index and occupational exposure to asbestos. Conclusion: Our study provides valuable information on patterns and trends of disease burden and risk factors attributable to ovarian cancer across age, socio-demographic index, region, and country, which may help improve the rational allocation of health resources as well as inform health policies.

Keywords: Global Burden of Disease (GBD); death; disability adjusted life-years; incidence; ovarian cancer.

Figure 1

The incidence burden of ovarian cancer in 195 countries and territories. (A) The ASIR (per 100,000 people) of ovarian cancer globally in 2017; American Samoa, Pakistan, Brunei, Seychelles, and Greenland had the top 5 ASIR in 2017. (B) The relative change (%) in incident cases of ovarian cancer between 1990 and 2017; the greatest changes were exhibited in Venezuela and Sweden. (C) The EAPC of ovarian cancer ASIR from 1990 to 2017; the greatest EAPC were exhibited in Trinidad and Tobago, and Sweden. ASIR, age-standardized incidence rate; EAPC, estimated annual percentage change.

Figure 2

The changes of age-standardized rates of different SDI quintiles from 1990 to 2017 (per 100,000). (A) ASIR, age standardized incidence rate; (B) ASDR, age standardized death rate; (C) DALY, disability adjusted life-year. SDI, socio-demographic index; GBD, global burden of diseases.

Figure 3

The correlation between EAPC and ovarian cancer ASR (per 100,000) in 1990 as well as SDI in 2017. The circles represent countries and territories that were available on SDI data. The size of circle is increased with the cases of ovarian cancer. The R and P-values presented were derived from Pearson correlation analysis. (A) EAPC and SDI in incidence; (B) EAPC and ASIR; (C) EAPC and SDI in death; (D) EAPC and ASDR; (E) EAPC and SDI in DALYs; (F) EAPC and age-standardized DALY rate. ASIR, age standardized incidence rate; ASDR, age standardized death rate; EAPC, estimated annual percentage change; SDI, socio-demographic index; DALY, disability adjusted life-year.

Figure 4

The ovarian cancer DALYs attributable to risk factors compared in 1990 (A) and 2017 (B) by SDI quintiles. DALY, disability-adjusted life year.

Figure 5

The age-standardized rates of DALYs and deaths (per 100,000) attributable to all risks (A,E), high fasting plasma glucose (B,F), high body mass index (BMI) (C,G), and occupational exposure to asbestos (D,H) globally and in all SDI quintiles from 1990 to 2017.