Global burden and projected trends of ovarian cancer in older women: A GBD 2021 analysis

Our plain-English summary of Global burden and projected trends of ovarian cancer in older women: A GBD 2021 analysis, by X. Li, L. Yang, C. Wang, et al (Tropical Medicine and Health, 2026).

The study

• Authors: X. Li, L. Yang, C. Wang, C. He, S. Zhao, Z. Du, J. Ma, J. Hua, Q. Zhou, H. Lin, P. Li
• Journal: Tropical Medicine and Health
• Published: 2026;54(1)
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: As the population ages worldwide, ovarian cancer (OC) poses a serious public health issue for elder women. The objective of this study is to outline the global impact of OC in individuals aged 60 and above from 1990 to 2021, thus guiding specific policies and approaches for prevention, screening, and treatment.

Methods: A global secondary data analysis using the Global Burden of Disease (GBD) 2021 data was performed to estimate the burden and project future trends of OC in older women (aged 60 and above). We gathered data regarding incidence, mortality rates, and disability-adjusted life years (DALYs) from the GBD 2021. For trend analysis, we employed joinpoint regression to assess temporal variations, calculating the average annual percentage change (AAPC) to quantify these trends. Furthermore, we used the age-period-cohort (APC) model to examine the influences of age, time, and birth cohort on incidence, mortality, and DALY figures. Additionally, the Bayesian age-period-cohort (BAPC) model was applied to forecast changes extending to the year 2050.

Results: A worldwide assessment of the impact of OC on public health from 1990 to 2021 highlights notable patterns: the age-standardized incidence rate (ASIR) showed a net decrease; however, its estimated annual percentage change (EAPC) was positive, indicating an overall upward trend in annual rates over the period. In contrast, the age-standardized prevalence rate (ASPR), the age-standardized DALYs, age-standardized death rate (ASDR), and the age-standardized mortality rate (ASMR) have all shown a decline. The distribution of the disease burden shows considerable regional disparities, with uncertainty analyses indicating a sustained decline in regions with a high socio‑demographic index (SDI) and a corresponding increase in regions with low‑to‑medium SDI. Among older women (aged 60 and above), the disease burden demonstrates a disproportionate concentration in younger elderly subgroups: the 60-64 age group experiences the highest incidence and prevalence burden, while mortality peaks in the 65-69 age group. This pattern is particularly pronounced in regions such as South Asia and Central Europe. Risk factor analysis identifies high body mass index (BMI) at 21% and occupational asbestos exposure at 7% as the two major risk factors contributing to OC mortality. Projections based on the BAPC model indicate that by 2050, the global prevalence of OC will continue to rise, while incidence rates are expected to persistently decline.

Conclusions: The global fight against OC confronts dual challenges: increasing incidence rates and a shifting disease burden toward low- and middle-income regions. Future efforts must embrace targeted global strategies that integrate improved prevention, diagnosis, treatment, and chronic disease management.

© 2026. The Author(s).

In plain English

This secondary analysis used Global Burden of Disease (GBD) 2021 estimates for ovarian cancer in women aged 60 and older, 1990 to 2021, with projections to 2050. Globally, age-standardized rates per 100,000 changed as follows. Prevalence went from 14.1 (13.0–15.5) in 1990 to 14.3 (12.9–15.6) in 2021. Incidence went from 3.8 (3.5–4.2) to 3.5 (3.1–3.8), though its estimated annual percentage change was positive, 0.7% (0.6–0.7). Mortality went from 2.6 (2.4–2.8) to 2.2 (1.9–2.3). Age-standardized incidence fell in high socio-demographic index (SDI) regions, from 6.5 (6.2–6.7) to 4.4 (4.1–4.6) per 100,000. It rose in low-SDI regions, from 1.8 (1.2–2.6) to 2.8 (2.1–3.3). Case numbers peaked at ages 60–64 and deaths at 65–69. Under the GBD risk model, occupational asbestos exposure accounted for 7% (5–9%) of ovarian cancer deaths globally in 2021, and high body mass index for 21% (15–28%). No fiber types were named. Projected age-standardized prevalence rates rose, and incidence rates fell, to 2050. The authors concluded that ovarian cancer poses dual challenges: increasing incidence and a burden shifting toward low- and middle-income regions. They noted the analysis cannot establish causality.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Secondary (ecological) analysis of Global Burden of Disease 2021 estimates. Methods were trend analysis (EAPC, joinpoint regression), age-period-cohort modelling, and Bayesian age-period-cohort projections to 2050.
• Who was studied: Women aged 60 and older with ovarian cancer, as estimated in GBD 2021 for 204 countries and territories, 1990 to 2021. Results were grouped by 21 GBD regions and 5 SDI levels.
• Exposure: Risk factors modelled in the GBD 2021 Comparative Risk Assessment framework. The two largest for ovarian cancer deaths were high body mass index and occupational exposure to asbestos. The article does not name fiber types or give doses.
• Main results:
  • Globally, the age-standardized prevalence rate went from 14.1 (13.0, 15.5) per 100,000 in 1990 to 14.3 (12.9, 15.6) per 100,000 in 2021
  • Globally, the age-standardized incidence rate fell from 3.8 (3.5, 4.2) per 100,000 in 1990 to 3.5 (3.1, 3.8) per 100,000 in 2021
  • Despite the net decrease, the estimated annual percentage change for incidence was printed as positive: 0.7% (0.6, 0.7)
  • Globally, the age-standardized mortality rate fell from 2.6 (2.4, 2.8) per 100,000 in 1990 to 2.2 (1.9, 2.3) per 100,000 in 2021. Its EAPC was printed as 0.6 (0.6, 0.7).
  • In high-SDI regions, the age-standardized incidence rate fell from 6.5 (6.2 to 6.7) per 100,000 in 1990 to 4.4 (4.1 to 4.6) per 100,000 in 2021
  • In low-SDI regions, the age-standardized incidence rate rose from 1.8 (1.2 to 2.6) per 100,000 to 2.8 (2.1 to 3.3) per 100,000 over the same period
  • Among women 60 and older, in both 1990 and 2021, the highest numbers of cases, prevalence and DALYs were in the 60–64 age group. The highest number of deaths was in the 65–69 age group.
  • Under the GBD 2021 model, high BMI accounted for 21% (15–28%) of ovarian cancer deaths globally in 2021, and occupational exposure to asbestos for 7% (5–9%). The text does not state whether these fractions are limited to women aged 60 and older.
  • Projections to 2050 for women 60 and older showed an upward trend in the global age-standardized prevalence rate and a declining trend in the age-standardized incidence rate. These are rates, not case counts, and are presented with 95% uncertainty intervals.
• The authors' conclusion: The authors concluded that the global fight against ovarian cancer faces dual challenges: increasing incidence rates, and a disease burden shifting toward low- and middle-income regions
• Limitations the authors state:
  • As an ecological analysis of aggregated data, it cannot establish causality or examine individual-level confounders
  • The findings depend on GBD 2021 estimates, which carry uncertainty from input data quality and modelling, especially where data are missing
  • There were no data on histological subtype, so trends and risks for different ovarian cancer subtypes could not be analysed
  • The trend and projection models assume past trends will continue and may not capture future disruptions
  • Attributable risk estimates cover only the factors in the GBD framework, and do not capture combined effects or all potential risks

Topics

Medical terms in this study, explained in our Lexicon: Ovarian Cancer, Incidence, Asbestos Exposure.

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