Burden and Trends of Six Gynecological Diseases Among Chinese Women Aged 15–49 Years, 1990–2021: Evidence from GBD 2021

Introduction: This study examines the burden of six gynecological system diseases (uterine fibroids, polycystic ovarian syndrome, endometriosis, cervical cancer, ovarian cancer, and uterine cancer) in Chinese women aged 15– 49 years from 1990 to 2021. Methods: This research used data on the incidence and disability-adjusted life-years (DALYs) of six gynecological diseases from the GBD 2021 study. The Joinpoint Regression Program 5.2.0 was employed to analyze age-standardized incidence rates (ASIR), DALY rates, and estimated annual percentage change (EAPC). Results: In China, uterine fibroids had the highest ASIR (271.82/100,000), while cervical cancer had the highest age-standardized DALY rate (117.11/100,000). Between 1990 and 2021, polycystic ovarian syndrome (PCOS) exhibited the fastest ASIR growth (EAPC=1.62) and DALY rate (EAPC=2.09), while cervical cancer incidence also rose (EAPC=1.24). The burden showed distinct age-specific patterns: Uterine fibroids had the fastest growth in age-standardized DALY rate (EAPC=1.46). PCOS was concentrated in the 15– 19 age group and showed the fastest growth (ASIR 317.17/100,000, EAPC=1.96). Ovarian cancer showed the largest increases in low‑middle SDI regions (ASIR EAPC=1.69; age-standardized DALY rate EAPC=1.29). Conclusion: The burden of six gynecological diseases among Chinese women of reproductive age varies significantly by age and time. Cervical cancer causes the most severe health loss. Polycystic ovarian syndrome demonstrates a prominent burden among younger women with a clear upward trend. Notably, China faces accelerated growth in both polycystic ovary syndrome and uterine fibroids, while ovarian cancer showed the largest increases in low-middle SDI regions. Finding provide essential evidence to guide age-tailored prevention, early detection, and resource allocation strategies in China and other countries undergoing similar epidemiological transitions.