Investigation of the trends and associated factors of ovarian cancer in Indonesia: A systematic analysis of the Global Burden of Disease study 1990-2021

Our plain-English summary of Investigation of the trends and associated factors of ovarian cancer in Indonesia: A systematic analysis of the Global Burden of Disease study 1990-2021, by B.A. Tjokroprawiro, K. Novitasari, R.A. Ulhaq, et al (PloS One, 2025).

The study

• Authors: B.A. Tjokroprawiro, K. Novitasari, R.A. Ulhaq, H.A. Sulistya, S. Martini
• Journal: PloS One
• Published: 2025;20(1):e0313418
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Ovarian cancer is one of the most lethal gynecological cancers. Despite diagnosis and treatment advances, survival rates have not increased over the past 32 years. This study estimated and reported the global burden of ovarian cancer during the past 32 years to inform preventative and control strategies.

Methods: We examined ovarian cancer incidence, mortality, and disability-adjusted life years (DALYs) using age-standardized rates from the Global Burden of Disease, Injuries, and Risk Factors Study 2021. high body mass index and occupational asbestos exposure were linked with death and DALYs. Data are presented as averages with 95% uncertainty intervals (UIs).

Results: Indonesia had 13 250 (8 574-21 565) ovarian cancer cases in 2021, with 5 296 (3 520-8958) deaths and 186 917 (121 866-309 820) DALYs. The burden increased by 233.53% for new cases, 221.95% for mortalities, and 206.65% for DALYs. The age-standardized rate also increased from 1990 to 2021. Ovarian cancer burden increased with age but declined in the 50+ year age group. According to the sociodemographic index, the gross domestic product per capita and number of obstetricians and oncologic gynecologists in provinces showed different trends.

Conclusions: Indonesian ovarian cancer rates are rising despite gynecologic oncologists in 24 of 34 provinces. These findings will help policymakers and healthcare providers identify ovarian cancer prevention and control gaps.

Copyright: © 2025 Tjokroprawiro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

In plain English

This study analyzed modeled Global Burden of Disease 2021 estimates of ovarian cancer among Indonesian women, nationally and in 34 provinces, 1990 to 2021. Estimated new cases rose from 3973 (95% uncertainty interval 2716 to 7573) in 1990 to 13 250 (8574 to 21 565) in 2021, a 233.53% change. Estimated deaths in 2021 were 5 296 (3 520 to 8958). The age-standardized rate of disability-adjusted life years rose from 92.69 (65.70 to 171.80) to 126.56 (83.24 to 210.85) per 100 000. High body mass index and work-related asbestos exposure were named the two leading risk factors for ovarian cancer deaths, in a passage worded as deaths worldwide. High body mass index was linked to more deaths than any other risk factor in 2021: 240.23 (35.30 to 509.91). The running text gave no asbestos-specific number. Provinces with higher sociodemographic index or income per person had lower death-to-case ratios. Neither measure correlated significantly with age-standardized rates. Provinces with more gynecologists had higher estimated case and death counts, a correlation only. The authors concluded that targeted, up-to-date prevention strategies are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Secondary descriptive analysis of Global Burden of Disease Study 2021 estimates, with correlation analysis at the provincial level
• Who was studied: Women in Indonesia, at the national level and in 34 provinces, 1990 to 2021 (GBD modeled estimates)
• Exposure: The GBD risk factors for ovarian cancer deaths were high body mass index and work-related (occupational) asbestos exposure. The study also examined provincial sociodemographic index, GDP per capita, and the numbers of obstetric gynecologists and oncologic gynecologists. No asbestos doses or fiber types were given.
• Main results:
  • Estimated ovarian cancer cases in Indonesia rose from 3973 (95% UI 2716–7573) in 1990 to 13 250 (95% UI 8574–21 565) in 2021, a 233.53% change.
  • In 2021 there were an estimated 5 296 ovarian cancer deaths in Indonesia (95% UI 3 520–8958).
  • The national age-standardized DALY rate rose from 92.69 (95% UI 65.70–171.80) in 1990 to 126.56 (95% UI 83.24–210.85) in 2021, a 36.54% change.
  • High body mass index and work-related asbestos exposure were named the two leading risk factors for ovarian cancer deaths in 1990 and 2021. The passage words this as deaths globally and worldwide.
  • In 2021, among the risk factors, high body mass index led to the highest number of ovarian cancer deaths: 240.23 (95% UI 35.30–509.91). This equals an age-standardized death rate of 0.16 (95% UI 0.02–0.35) per 100 000. The running text gives no asbestos-specific number.
  • The age-standardized death rate due to all risk factors rose 500%, from 0.03 (95% UI -0.01 to 0.08) to 0.18 (95% UI 0.04 to 0.37).
  • Across provinces, sociodemographic index was not significantly correlated with the age-standardized incidence rate (Pearson r2 = 0.001, p = 0.837), death rate or DALY rate.
  • Sociodemographic index was significantly negatively correlated with the mortality-to-incidence ratio (Pearson r2 = 0.131, p = 0.035).
  • GDP per capita was significantly negatively correlated with the mortality-to-incidence ratio (Pearson r2 = 0.223, p = 0.005).
  • Indonesia had 4 895 obstetric gynecologists in 2021. Their number by province was positively correlated with the estimated numbers of ovarian cancer cases (Pearson r2 = 0.778, p < 0.001), deaths and DALYs. It was not significantly correlated with the mortality-to-incidence ratio.
  • Indonesia had 121 oncologic gynecologists in 2021. Their number was positively correlated with the estimated case, death and DALY counts by province, but not with the mortality-to-incidence ratio.
• The authors' conclusion: The authors concluded that ovarian cancer incidence, mortality and DALYs were significantly correlated with the number of obstetric gynecologists and gynecologic oncologists. They also concluded that targeted, up-to-date preventive strategies for ovarian cancer are required.
• Limitations the authors state:
  • The study relied on GBD data and mathematical models rather than primary data sources, which may introduce biases or inaccuracies.
  • Differences in cancer surveillance and reporting between provinces could partly explain the observed differences between provinces.
  • No clinical staging or detailed histological information was included.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Ovarian Cancer, Asbestos Exposure.

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