Trends and cross-country inequalities in the global burden of female genital prolapse from 1990 to 2021: A population-based study

Background: To assess the trends and cross-country disparities in the burden of female genital prolapse (FGP) over the past 30 years and to project its changes through 2036.Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we analyzed age-standardized incidence, prevalence, and disability-adjusted life-years (DALYs) across 204 countries. Joinpoint regression, decomposition, and Bayesian Age-Period-Cohort(APC) models were applied to assess trends, drivers, and projections.Results: In 2021, FGP accounted for 13.97 million incident cases (95% UI: 11.65–16.61 million) and 124.38 million prevalent cases (95% UI: 103.41–148.05 million), with 389,358 DALYs (95% UI: 191,055–731,017). Age-standardized rates declined globally (AAPC for incidence: −0.53%, 95% CI: −0.56 to −0.51), yet regional disparities persisted: South Asia reported the highest ASIR (401.57/100,000), while high-income Asia Pacific had the lowest (139.15/100,000).The slope index of inequality (SII) for DALYs rose from 1.37 (95% CI: −1.37–4.11) in 1990 to 4.95 (2.48–7.42) in 2021, with concentration indices (CI) of −0.495 (1990) and −0.454 (2021).Frontier analysis linked socio-economic disparities to divergent DALYs burdens across nations.Decomposition analysis revealed population aging (+110.8%) and epidemiological changes (−51.7%) as key drivers.Age-standardized rates are expected to decline further by 2036, though demographic shifts may elevate absolute case numbers.Conclusions: FGP burden has decreased globally but remains concentrated in aging and underserved populations. Prioritizing preventive care and equitable resource distribution is critical for achieving health equity.