The burden of ovarian cancer attributable to occupational asbestos exposure in Asia from 1990 to 2021: an analysis of the global burden of disease study 2021

Our plain-English summary of The burden of ovarian cancer attributable to occupational asbestos exposure in Asia from 1990 to 2021: an analysis of the global burden of disease study 2021, by Y. Yu, W. Zhang, T. Deng, et al (Tropical Medicine and Health, 2026).

The study

• Authors: Y. Yu, W. Zhang, T. Deng, N. Li, J. Wu
• Journal: Tropical Medicine and Health
• Published: 2026;54(1)
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Ovarian cancer (OC) ranks among the deadliest gynecological malignancies worldwide. Occupational asbestos exposure has been linked to an elevated risk of OC. Asia accounts for a substantial share of global asbestos consumption; nevertheless, regional analyses focusing on OC burden attributable to occupational asbestos exposure under the Global Burden of Disease (GBD) framework remain scarce.

Objectives: This study aimed to assess the burden of OC attributable to occupational asbestos exposure across Asia and delineate its temporal trends from 1990 to 2021.

Methods: Data on all-age deaths, disability-adjusted life years (DALYs), age-standardized rates, and crude rates of OC attributable to occupational asbestos exposure among Asian females were retrieved from the 2021 GBD dataset and its comparative risk assessment framework for subsequent burden analyses. The Age-Period-Cohort (APC) model was adopted to characterize long-term trends of the disease burden, although decomposition analysis was performed to quantify the respective contributions of population growth, population aging, and epidemiological shifts.

Results: Between 1990 and 2021, the age-standardized mortality rate (ASMR) of OC attributable to occupational asbestos exposure in Asia declined from 0.41 per 10,000 population to 0.37 per 10,000 population, with an estimated annual percentage change (EAPC) of - 0.29 (95% CI - 0.52, - 0.06). Meanwhile, the age-standardized DALY rate (ASDR) decreased from 7.89 per 10,000 population to 6.74 per 10,000 population (EAPC = - 0.50, 95% CI - 0.66, - 0.33). Over the study period, the total number of deaths and DALYs increased by 161.10% and 131.38%, respectively. Marked regional disparities were observed: ASMR and ASDR trended upward in South and Southeast Asia, declined in high-income Asia-Pacific regions, and stayed relatively stable across East Asia, with Central Asia bearing the highest overall disease burden. In terms of age distribution, OC burden increased with advancing age, peaked in the 70-74 age group and then declined gradually. Both crude mortality rate (CMR) and crude DALY rate (CDR) exhibited rising tendencies among the elderly population. APC analysis revealed that the age effects for mortality and DALY rates increased among middle-aged and older adults but decreased in the advanced age groups. Period effects presented an overall upward trend, whereas cohort effects declined generally. Decomposition analysis identified population aging and population expansion as the primary drivers of the growth in absolute disease burden, and epidemiological transitions exerted a mitigating effect on the overall OC burden.

Conclusions: Based on estimations from the GBD 2021 framework, the age-standardized burden of OC attributable to occupational asbestos exposure has fallen across Asia. However, the absolute burden continues to climb due to population growth and aging, accompanied by prominent regional heterogeneity. Targeted interventions regarding data surveillance, exposure regulation, and occupational health policies are therefore urgently required for future prevention and control.

© 2026. The Author(s).

In plain English

This study used modelled Global Burden of Disease (GBD) 2021 estimates of ovarian cancer deaths and disability-adjusted life years (DALYs, combining years lost to early death and to illness) that GBD attributes to occupational asbestos exposure among women in Asia from 1990 to 2021. Asbestos fiber types were not distinguished. Across Asia, the age-standardized death rate fell from 0.41 (uncertainty interval 0.19 to 0.70) to 0.37 (0.17 to 0.63) per 10,000 population, and the age-standardized DALY rate from 7.89 (3.54 to 13.83) to 6.74 (3.03 to 11.72) per 10,000. Total deaths, however, rose by 161.10% and DALYs by 131.38%. A decomposition analysis attributed this mainly to population growth and aging. Rates rose in South and Southeast Asia, fell in the High-income Asia Pacific region, stayed relatively stable in East Asia, and were highest in Central Asia. Numbers of deaths and DALYs peaked at ages 70–74. The authors concluded that the age-standardized burden fell while absolute numbers kept rising, with marked regional differences. They cautioned that these are model-based population estimates, not individual exposure measurements, and that country comparisons need caution.

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 analysis of modelled Global Burden of Disease 2021 estimates (comparative risk assessment), with trend analysis, age-period-cohort modelling and decomposition analysis
• Who was studied: Females across Asia, its five subregions (Central Asia, High-income Asia Pacific, South Asia, East Asia, Southeast Asia) and 34 countries and territories, 1990 to 2021. These are GBD population-level estimates, not individual records.
• Exposure: Occupational asbestos exposure overall, inferred indirectly in GBD through the asbestos impact ratio. Chrysotile, amphibole asbestos and other types were not distinguished, and there was no stratification by intensity, duration or occupation.
• Main results:
  • Asia: the age-standardized mortality rate for ovarian cancer attributable to occupational asbestos exposure fell from 0.41 (95% UI 0.19 to 0.70) per 10,000 population in 1990 to 0.37 (95% UI 0.17 to 0.63) in 2021 (EAPC -0.29, 95% CI -0.52 to -0.06)
  • Asia: the age-standardized DALY rate fell from 7.89 (95% UI 3.54 to 13.83) per 10,000 population in 1990 to 6.74 (95% UI 3.03 to 11.72) in 2021 (EAPC -0.50, 95% CI -0.66 to -0.33)
  • Asia: the absolute number of deaths rose by 161.10% and DALYs by 131.38% from 1990 to 2021, with population growth as the leading contributor. Epidemiological changes contributed -23.27% to deaths and -28.30% to DALYs.
  • South Asia: rising trends in the age-standardized mortality rate (EAPC 2.40, 95% CI 2.20 to 2.60) and the age-standardized DALY rate (EAPC 2.36, 95% CI 2.17 to 2.55). Southeast Asia also rose (EAPCs 1.82 and 1.74).
  • High-income Asia Pacific: declining trends (EAPC -0.42 for the age-standardized mortality rate, -0.74 for the age-standardized DALY rate). East Asia: relatively stable.
  • Central Asia had the highest age-standardized mortality and DALY rates in 2021 (0.82 and 18.23 per 10,000 in Table 1). Among countries, Armenia had the highest rates in 2021.
  • Age-period-cohort analysis: the age effect for mortality peaked at ages 70–74 (RR 45.68). The period effect for mortality rose from 0.30 in 1992–1996 to 3.10 in 2017–2021. The cohort effect for mortality fell from 66.77 (1897–1901 cohort) to 0.01 (1997–2001 cohort).
• The authors' conclusion: The authors concluded that the age-standardized burden of ovarian cancer attributable to occupational asbestos exposure in Asia declined from 1990 to 2021, while absolute deaths and DALYs kept rising with population growth and aging, with substantial regional and country heterogeneity.
• Limitations the authors state:
  • All analyses rest on modelled GBD estimates, not direct measurements of individual exposure or paired case-exposure data
  • Data completeness varies widely across Asian countries, so cross-country comparisons and rankings should be interpreted with caution
  • Fiber types were not distinguished, and exposure intensity, duration and occupational group could not be analysed
  • The study could not fully account for other occupational exposures, co-exposures and unmeasured confounders
  • The age-period-cohort and decomposition methods are population-level and descriptive, and cannot show individual risk or causal effects of policies

Topics

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

Related studies

• Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019 — Y. Zhang, M. Mi, et al. (2023)
• Global, regional, and national burden of non-communicable diseases attributable to occupational asbestos exposure 1990-2019 and prediction to 2035: worsening or improving? — X. Miao, T. Yao, et al. (2024)
• Deaths burden of laryngeal cancer attributable to occupational exposure in the male working age population: findings from global burden of disease study 2021 — D. Wang, S. Yang, et al. (2025)
• Global Burden, Projection, and Inequalities Analysis of Cancer Attributable to Occupational Carcinogen Exposure in Individuals Aged Over 40 Years — N. Hu, H. Li, et al. (2025)
• Global burden of mesothelioma attributable to occupational asbestos exposure in 204 countries and territories: 1990-2019 — Z. Chen, Y. Cai, et al. (2024)
• The global burden of cancers attributable to occupational factors, 1990-2021 — B. Zou, P. Wu, et al. (2025)

Browse return to medical research.