Background: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder affecting adolescent girls globally. Despite its prevalence, the global burden of adolescent PCOS has not been systematically assessed. This study aims to evaluate the worldwide impact of PCOS among adolescents from 1990 to 2021 and forecast its future trajectory using data from the Global Burden of Disease (GBD) Study 2021. Methods: We analyzed trends in incidence, prevalence, and disability-adjusted life years (DALYs) associated with adolescent PCOS using GBD 2021 data. The analysis was stratified by age, socio-demographic index (SDI), and geographic region. Temporal trends were assessed using the estimated annual percentage change (EAPC). Health inequality analysis and frontier analysis were applied to examine disparities and identify potential for burden reduction. An autoregressive integrated moving average model was used to forecast the future burden of adolescent PCOS from 2022 to 2041. Results: The global age-standardized incidence rate of adolescent PCOS increased from 268.64 per 100,000 in 1990 to 348.21 per 100,000 in 2021 (EAPC: 0.81%). The prevalence rate rose from 1176.61 per 100,000 to 1526.36 per 100,000 (EAPC: 0.89%), and the DALYs rate increased from 10.53 to 13.62 per 100,000 (EAPC: 0.88%). Health inequality analysis revealed a widening gap between high- and low-SDI regions, with a disproportionate concentration of burden in higher-SDI countries. Frontier analysis identified countries like Italy and Japan as having greater potential for burden reduction. Southeast Asia exhibited the most rapid growth, with EAPCs exceeding 2.4%—approximately three-fold higher than the global average. Conclusion: The global burden of adolescent PCOS has steadily increased from 1990 to 2021, with significant regional disparities. The widening health inequality and rapid growth in Southeast Asia underscore the urgent need for targeted public health interventions. The projected rise in burden underscores the urgent need for targeted public health interventions, especially in regions with rapid increases in incidence and prevalence. Plain Language Summary: PCOS represents one of the most common hormonal disorders affecting adolescent females, typically characterized by disrupted menstrual cycles, elevated androgen levels, and an increased risk of enduring reproductive and metabolic health issues. This study investigates the global epidemiological trends of PCOS in adolescents, with a particular focus on its increasing prevalence in Southeast Asia and low-income regions. The results reveal a marked increase in both the occurrence and overall burden of the disease over the last thirty years. By 2021, the worldwide age-standardized incidence rate had surpassed 348 cases per 100,000 adolescent females. The study further reveals a growing disparity in healthcare access, with low-income countries experiencing a more rapid escalation in PCOS burden, underscoring the need for improved diagnostic capacity and treatment infrastructure. Forecasts suggest that this upward trend will persist in the coming years, highlighting the urgent need for enhanced early detection, preventive strategies, and equitable healthcare interventions, particularly in high-risk and underserved populations. Keywords: disability-adjusted life years, frontier analysis, global burden of disease, health inequality, polycystic ovary syndrome
Cao et al. (Sun,) studied this question.