Global trend analysis and risk evolution of asbestos-related ovarian cancer: a population-based study and future prediction (1990-2021)

Our plain-English summary of Global trend analysis and risk evolution of asbestos-related ovarian cancer: a population-based study and future prediction (1990-2021), by X. Li, J. Li, D. Shan, et al (Frontiers in Public Health, 2025).

The study

• Authors: X. Li, J. Li, D. Shan, M. Zhou, L. Mengna, Y. Li, M. Xia, H. Deng
• Journal: Frontiers in Public Health
• Published: 2025;13:1698477
• Read it: PubMed · Publisher · Free full text

Abstract

Existing evidence demonstrates that asbestos exposure is an environmental risk factor for ovarian cancer (OC). Using comprehensive data from the 2021 Global Burden of Disease Study, this research quantified the epidemiological burden of asbestos-related ovarian cancer. In 2021, asbestos exposure accounted for 5,587 OC deaths-a 51.2% increase from 1990. However, the age-standardized mortality rate (ASMR) decreased from 0.11 (95% UI: 0.05-0.17) to 0.07 (95% UI: 0.03-0.11) per 100,000 people between 1990 and 2021. Similarly, the disability-adjusted life-year (DALY) rate declined from 1.93 (95% UI: 0.92-3.03) to 1.15 (95% UI: 0.56-1.85) per 100,000 people, reflecting a 40.4% reduction in total DALYs. Projections based on the Bayesian age-period-cohort (BAPC) model indicate declining incidence and mortality rates over the next 25 years. These findings suggest asbestos' role as an independent OC risk factor is diminishing, warranting further investigation into its synergistic effects and co-pathogenesis with other etiological factors.

Copyright © 2026 Li, Li, Shan, Zhou, Mengna, Li, Xia and Deng.

In plain English

This study used Global Burden of Disease Study 2021 estimates of worldwide ovarian cancer deaths and disability-adjusted life years (DALYs, a measure of healthy life lost) attributed to occupational asbestos exposure, 1990 to 2021. It did not name fiber types. Estimated deaths rose from 3,694 (95% uncertainty interval 1,778 to 5,799) in 1990 to 5,587 (2,714 to 9,036) in 2021, and DALYs rose from 71,726 (34,302 to 112,279) to 98,122 (47,184 to 156,828). Age-standardized rates per 100,000 fell: deaths from 0.11 (0.05 to 0.17) to 0.07 (0.03 to 0.11), and DALYs from 1.93 (0.92 to 3.03) to 1.15 (0.56 to 1.85). In 2021, high-SDI (more socioeconomically developed) regions had the most deaths, 3,397 (1,601 to 5,448), and death counts peaked at ages 80 to 84. A forecast to 2046 estimated 6,167 deaths and 123,014 DALYs, but the article describes the direction of projected rates inconsistently. The authors concluded that the significance of asbestos as an independent risk factor for ovarian cancer is waning. They noted that peritoneal mesothelioma misclassified as ovarian cancer in older records could inflate historical estimates.

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: Population-based secondary analysis of Global Burden of Disease (GBD) 2021 estimates, using the GBD comparative risk assessment framework, with trend analysis and a forecasting model to 2046
• Who was studied: Global GBD 2021 estimates of ovarian cancer (ICD-10 code C56) by region, Socio-Demographic Index (SDI) tier and age group, 1990 to 2021
• Exposure: Occupational asbestos exposure as modeled by GBD, treated as a distinct risk factor. No fiber types, products or doses are given.
• Main results:
  • Global ovarian cancer deaths attributed to asbestos exposure rose from 3,694 (95% UI: 1,778 to 5,799) in 1990 to 5,587 (95% UI: 2,714 to 9,036) in 2021
  • Global asbestos-related ovarian cancer DALYs rose from 71,726 (95% UI: 34,302 to 112,279) in 1990 to 98,122 (95% UI: 47,184 to 156,828) in 2021
  • Global age-standardized death rate fell from 0.11 (95% UI: 0.05 to 0.17) per 100,000 in 1990 to 0.07 (95% UI: 0.03 to 0.11) in 2021. Age-standardized DALY rate fell from 1.93 (95% UI: 0.92 to 3.03) to 1.15 (95% UI: 0.56 to 1.85) per 100,000.
  • In 2021, high-SDI regions had the most asbestos-attributed ovarian cancer deaths, 3,397 (95% UI: 1,601 to 5,448), and the most DALYs, 54,600 (95% UI: 26,157 to 86,834)
  • In 2021, Europe had the highest asbestos-related ovarian cancer deaths: 3,197 (95% UI: 1,542 to 5,057)
  • In 2021, death counts peaked in the 80 to 84 age group and DALY counts in the 70 to 74 age group
  • Between 1990 and 2021, rates fell substantially in high and high-middle SDI regions, with minimal change elsewhere. The table shows rising death rates in low SDI regions (estimated annual percentage change 3.22, 95% CI 3.07 to 3.36).
  • The forecast estimated 6,167 deaths and 123,014 DALYs from asbestos-linked ovarian cancer over the 2022 to 2046 projection period. The article does not make clear whether these figures are totals or yearly values.
• The authors' conclusion: The authors concluded that the significance of asbestos exposure as an independent risk factor for ovarian cancer is waning. They called for research on other environmental exposures, on mechanisms, and on combined effects of multiple risk factors.
• Limitations the authors state:
  • Reliance on retrospective GBD datasets may introduce estimation bias
  • Peritoneal mesothelioma may have been misclassified as ovarian cancer in earlier records, which could overestimate the asbestos-attributable fraction in historical data
  • The forecasts rely on static assumptions about unmodeled confounding factors over the 25-year projection window
  • Regional estimates may have wider uncertainty, especially in low-SDI regions with weaker registry systems

Topics

The National Library of Medicine indexes this study under subjects our site covers: Ovarian cancer.

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

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