Trends and projections of polycystic ovary syndrome burden in China: Insights from the Global Burden of Disease Study 2021

Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age, associated with reproductive, metabolic, and psychological complications. In China, the burden of PCOS remains poorly characterized, particularly amid changing demographics and lifestyle patterns. This study evaluates trends in PCOS incidence, prevalence, and disability-adjusted life-years (DALYs) from 1990 to 2021 and projects the future burden through 2035. Methods Data on PCOS incidence, prevalence, and DALYs for Chinese women aged 10–54 years were extracted from the Global Burden of Disease Study 2021. Age-specific and age-standardized rates were calculated. Temporal trends were assessed using estimated annual percentage changes (EAPCs), and decomposition analysis quantified contributions of epidemiological changes, population growth, and aging. Projections through 2035 were based on current trends. Results From 1990 to 2021, PCOS incidence and prevalence showed significant increases, especially in younger age groups. Among 10–14-year-olds, incidence rose from 73,615 cases (95% UI: 35,399−124,529) to 128,219 cases (95% UI: 65,776–211,113), while prevalence increased from 124,220 (95% UI: 59,649–211,274) to 216,398 cases (95% UI: 110,028–357,026). Age-standardized rates are projected to rise to 70.82 (95% CI: 45.39–96.26) and 1,661.80 (95% CI: 1,467.99–1,855.62) per 100,000 by 2035, respectively. Decomposition analysis showed epidemiological changes as the primary driver of increased burden. Conclusions The burden of PCOS in China has risen substantially over three decades and is projected to escalate further. Marked increases in PCOS incidence and prevalence were observed among younger age groups, indicating an earlier onset or diagnosis. These findings highlight a shifting burden toward younger age groups and underscore the importance of age-specific surveillance and prevention strategies to address the evolving epidemiology of PCOS in China.