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

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. 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. 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. 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.