The global burden and associated factors of ovarian cancer in 1990-2019: findings from the Global Burden of Disease Study 2019

Our plain-English summary of The global burden and associated factors of ovarian cancer in 1990-2019: findings from the Global Burden of Disease Study 2019, by S. Zhang, C. Cheng, Z. Lin, et al (BMC Public Health, 2022).

The study

• Authors: S. Zhang, C. Cheng, Z. Lin, L. Xiao, X. Su, L. Zheng, Y. Mu, M. Liao, R. Ouyang, W. Li, J. Ma, J. Cai, L. Liu, D. Wang, F. Zeng, J. Liu
• Journal: BMC Public Health
• Published: 2022;22(1):1455
• Cited by: 58 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Ovarian cancer (OC) is a major cause of cancer-related deaths among women. The aim of this study was to estimate and report data on the current burden of ovarian cancer worldwide over the past 30 years.

Method: Based on the data provided by GBD 2019, we collected and interpreted the disease data of ovarian cancer by incidence, mortality, disability-adjusted life-years (DALYs), and used corresponding age-standardized rates as indicators. Also, we categorized the data by attributed risk factors and captured deaths due to high fasting plasma glucose, occupational exposure to asbestos and high body-mass index, respectively. All outcomes in the study were reported using mean values and corresponding 95% uncertainty intervals (95% UI).

Results: Globally, there were 294422 (260649 to 329727) incident cases in 2019, and the number of deaths and DALYs were 198412 (175357 to 217665) and 5.36 million (4.69 to 5.95). The overall burden was on the rise, with a percentage change of 107.8% (76.1 to 135.7%) for new cases, 103.8% (75.7 to 126.4%) for deaths and 96.1% (65.0 to 120.5%) for DALYs. Whereas the age-standardized rates kept stable during 1990-2019. The burden of ovarian cancer increased with age. and showed a totally different trends among SDI regions. Although high SDI region had the declining rates, the burden of ovarian cancer remained stable in high-middle and low SDI regions, and the middle and low-middle SDI areas showed increasing trends. High fasting plasma glucose was estimated to be the most important attributable risk factor for ovarian cancer deaths globally, with a percentage change of deaths of 7.9% (1.6 to 18.3%), followed by occupational exposure to asbestos and high body mass index.

Conclusions: Although the age-standardized rates of ovarian cancer didn't significantly change at the global level, the burden still increased, especially in areas on the lower end of the SDI range. Also, the disease burden due to different attributable risk factors showed heterogeneous, and it became more severe with age.

© 2022. The Author(s).

In plain English

This was a secondary analysis of Global Burden of Disease Study 2019 (GBD 2019) estimates for ovarian cancer in women in 204 countries and territories, 1990 to 2019. In 2019 there were an estimated 294422 (260649 to 329727) new cases and 198412 (175357 to 217665) deaths worldwide. Case numbers rose 107.8% (76.1 to 135.7%) from 1990, while global age-standardized rates stayed stable. High fasting plasma glucose was linked to the most ovarian cancer deaths. Occupational exposure to asbestos, with no fiber types specified, was credited with 3.3% (1.5 to 5.4%) of ovarian cancer deaths in 2019. The article mostly ranks it second, but one results passage ranks it third, after high body-mass index. Its age-standardized death rate was 0.1 (0.1 to 0.2) per 100,000. Globally, that rate fell 24.9% (-46.7 to -7.4%) from 1990 to 2019. Among socio-demographic index (SDI) groups, only the high group showed a decrease, and elsewhere changes were not statistically significant. The authors concluded that the overall burden still increased, especially in lower-SDI areas. They said further research is needed to clarify the causal relationship between asbestos and ovarian cancer.

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 analysis of modeled estimates from the Global Burden of Disease Study 2019 (GBD 2019), including GBD's comparative risk assessment of attributable risk factors
• Who was studied: Women with ovarian cancer worldwide, as estimated by GBD 2019 for 204 countries and territories, 1990 to 2019, analysed by country, world region, five socio-demographic index (SDI) groups and three age groups (15 to 49, 50 to 69, 70 and over)
• Exposure: GBD-attributed risk factors for ovarian cancer deaths, chiefly high fasting plasma glucose, occupational exposure to asbestos and high body-mass index. No fiber types, jobs or doses are given.
• Main results:
  • Globally in 2019 there were an estimated 294422 (260649 to 329727) incident cases, 198412 (175357 to 217665) deaths and 5.36 million (4.69 to 5.95) DALYs from ovarian cancer.
  • The number of ovarian cancer cases rose 107.8% (76.1 to 135.7%) from 1990 to 2019, but global age-standardized rates stayed stable.
  • In the high SDI region, the age-standardized death rate for ovarian cancer fell by 24.0% (-30.3 to -12.3%) from 1990 to 2019.
  • Occupational exposure to asbestos was reported as contributing to 3.3% (1.5 to 5.4%) of all ovarian cancer deaths in 2019. The discussion, the abstract and one results paragraph call it the second-leading specific risk factor. Another results paragraph lists the top three as high fasting plasma glucose, high body-mass index, then asbestos.
  • The global age-standardized death rate for ovarian cancer attributed to occupational asbestos exposure was 0.1 (0.1 to 0.2) per 100,000, and it had decreased by 24.9% (-46.7 to -7.4%) by 2019 compared with 1990.
  • For ovarian cancer deaths attributed to asbestos, only the high SDI group showed a decrease in age-standardized death rate, of 26.8% (-47.9 to -7.1%). Changes in other SDI groups were reported as not statistically significant.
  • The global number of ovarian cancer deaths attributed to occupational exposure to asbestos rose by 62.7% (15.2 to 101.2%) from 1990 to 2019 (Table 3).
  • High fasting plasma glucose was the risk factor linked to the most ovarian cancer deaths in 2019: 15736 (3023 to 36227) deaths, an age-standardized death rate of 0.4 (0.1 to 0.8) per 100,000. That rate rose 34.7% (18.6 to 51.4%) over the period.
  • The age-standardized death rate for ovarian cancer attributed to high body-mass index was 0.1 (0.0 to 0.3) per 100,000, and it rose 16.4% (2.7 to 32.0%) from 1990 to 2019.
• The authors' conclusion: The authors concluded that, although global age-standardized rates of ovarian cancer did not significantly change, the burden still increased, especially in areas at the lower end of the SDI range. On asbestos, they stated that further scientific investigation is needed to clarify the causal relationship between asbestos and ovarian cancer.
• Limitations the authors state:
  • The accuracy of the results depends on the quality and quantity of GBD data, and GBD cannot cover all regions of the world.
  • Information may be missing for less developed countries.
  • Information bias is inevitable.
  • The authors could not separate histological subtypes of ovarian cancer, although risk factors may affect subtypes differently.

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, Occupational Exposure, Attributable Risk.

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• Global and regional burden of disease and injury in 2016 arising from occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016 — GBD 2016 Occupational Risk Factors Collaborators (2020)
• The global burden of cancers attributable to occupational factors, 1990-2021 — B. Zou, P. Wu, et al. (2025)
• Burden of ovarian cancer in China from 1990 to 2030: A systematic analysis and comparison with the global level — Y. Wang, Z. Wang, et al. (2023)
• Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019 — Y. Zhang, M. Mi, et al. (2023)

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