The Burden and Trends of Gynecological Cancers in Asia from 1980 to 2021, with Projections to 2050: A Systematic Analysis for the Global Burden of Disease Study 2021

Abstract

Gynecological cancers pose a significant threat to women's health. This study aimed to investigate the disease burden of cervical, uterine, and ovarian cancers in Asia from 1980 to 2021. The Global Burden of Disease 2021 database (GBD 2021) was used to conduct a cross-sectional study. The incidence, mortality rates, and disability-adjusted life years (DALYs) were obtained as indicators to estimate the burden. The effects of age, period, and cohort on the incidence of gynecological cancers were analyzed via the age-period-cohort web tool (APC-Web). The future trends of the gynecological cancer burden in Asia from 2025 to 2050 were predicted via a Bayesian age-period-cohort model. In 2021, cervical cancer exhibited the highest age-standardized mortality burden (3.1 deaths per 100,000; 95% UI: 2.7-3.4), whereas uterine cancer had the lowest (0.7 deaths per 100,000; 95% UI: 0.6-0.9). Geographically, South Asia has experienced the highest cervical cancer burden, with Seychelles, Mongolia, Cambodia, and Nepal ranking among the most affected nations. In contrast, Central Asia had the highest ovarian cancer burden, led by Georgia, followed by the United Arab Emirates, Seychelles, and Brunei Darussalam. Similarly, the uterine cancer burden was most pronounced in Central Asia, with Georgia, Armenia, Mauritius, and the United Arab Emirates exhibiting elevated rates. Finally, increasing trends in the burden of gynecological cancers were predicted across all age groups from 2025 to 2050, with women aged 60 to 64 years being the most affected. In conclusion, gynecological cancers are significant contributors to the disease burden in Asia. Improved early screening methods are essential to mitigate this increasing burden.

Keywords: Asia; cervical cancer; disease burden; gynecological cancers; ovarian cancer; uterine cancer.

Figure 1

Global age-specific disease burden attributable to three types of gynecological cancers by age group for mortality rate in 1980 (A); mortality rate in 2021 (B); DALY rate in 1990 (C); DALY rate in 2021 (D); incidence rate in 1990 (E); and incidence rate in 2021 (F). DALY = disability-adjusted life year.

Figure 2

Age-standardized mortality rates attributable to cervical cancer in 1990 (A); to cervical cancer in 2021 (B); to ovarian cancer in 1990 (C); to ovarian cancer in 2021 (D); to uterine cancer in 1990 (E); and to uterine cancer in 2021 (F). Red in the map indicates a high disease burden, whereas blue indicates a low disease burden. DALY = disability-adjusted life year.

Figure 3

Age-standardized rates for different SDI levels by countries in 2021 of mortality rate of cervical cancer (A); of DALY rate of cervical cancer (B); of incidence rate of cervical cancer (C); of mortality rate of ovarian cancer (D); of DALY rate of ovarian cancer (E); of incidence rate of ovarian cancer (F); of mortality rate of uterine cancer (G); of DALY rate of uterine cancer (H); and of incidence rate of uterine cancer (I); The solid black line is the fit curve. SDI = sociodemographic index. The different colors represent different countries. GBD = Global Burden of Disease Study.

Figure 4

Trends in the age-standardized DALY rates from 1990 to 2021 in Asia attributable to cervical cancer (A); ovarian cancer (B); and uterine cancer (C). DALY = disability-adjusted life year. * indicates that the trend is statistically significant. APC = annual percent change.

Figure 5

The predicted results from 1990 to 2050 by age group according to the BAPC model for age-standardized mortality rate of cervical cancer (A); age-specific death cases of cervical cancer (B); age-standardized mortality rate of ovarian cancer (C); age-specific death cases of ovarian cancer (D); age-standardized mortality rate of uterine cancer (E); age-specific death cases of uterine cancer (F) in Asia. The part behind the black vertical line is the predicted value. BAPC = Bayesian age-period-cohort.