Regional Heterogeneity and Future Challenges in Ovarian Cancer Burden in Asia

Ovarian cancer (OC) is a growing public health challenge in Asia, with rising incidence and regional disparities. Using the Global Burden of Disease (GBD) 2021 dataset, this study assessed temporal trends, spatial patterns, and determinants of OC burden in Asia from 1990 to 2021, with projections to 2036.

Data were extracted from GBD 2021 for all Asian regions. Three indicators were analyzed: age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR). Trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Decomposition analysis examined contributions of population aging, growth, and epidemiological shifts. Age-period-cohort (APC) analysis was performed to disentangle the effects of age, period, and cohort on OC incidence. Future burden (2022-2036) was projected with an autoregressive integrated moving average (ARIMA) model.

From 1990 to 2021, OC burden increased markedly. Southeast, South, and Central Asia had the greatest rises in ASIR, ASMR, and ASDR, while East Asia and high-income Asia Pacific showed stable or declining trends, likely due to healthcare advances and early detection. Higher sociodemographic index (SDI) correlated with greater incidence and mortality. Decomposition revealed aging as the main driver in East Asia and high-income Asia Pacific, while population growth dominated in South Asia. APC analysis highlighted age as the primary risk factor, with a rising period effect and a declining cohort effect. ARIMA projections (2022-2036) show steady ASIR growth and U-shaped trajectories (initial decline then rise) for ASMR and ASDR.

The increasing OC burden in Southeast, South, and Central Asia underscores the urgent need for region-specific strategies. Interventions focusing on early diagnosis, equitable healthcare, and addressing demographic and epidemiological drivers are essential to mitigate the projected rise by 2036.