Ovarian cancer global trends and disparities across 204 countries and territories

Ovarian cancer remains the deadliest gynecological malignancy and is frequently diagnosed at advanced stages. Updated global assessments are needed to quantify recent trends, forecast future disease burden, and characterize geographic disparities in outcomes.

We analyzed Global Burden of Disease 2023 estimates for ovarian cancer across 204 countries and territories from 1990 through 2023. Incident cases, deaths, disability-adjusted life years, and age-standardized incidence and mortality rates were evaluated. Early-onset ovarian cancer was defined as diagnosis before 50 years of age. Temporal trends were assessed using Joinpoint regression and summarized as average annual percentage changes. Disparities were examined using mortality-to-incidence measures, the Socio-Demographic Index. Global Burden of Disease forecasts were used to project incidence and mortality through 2050.

Globally, incident cases increased from 158,403 in 1990 to 338,615 in 2023. Deaths increased from 106,301 to 220,979, while the age-standardized mortality rate declined modestly from 6.29 to 5.95 per 100,000, corresponding to an average annual change of -0.44% (95% confidence interval, -0.52% to -0.36%). Early-onset incidence increased by an average of 0.26% annually (95% confidence interval, 0.04% to 0.48%). Mortality relative to incidence was inversely correlated with socioeconomic development (R² = 0.52), and frontier analyses indicated widening disparities in lower-development settings. High body mass index accounted for 6.37% of ovarian cancer deaths in 2023. By 2050, annual cases are projected to reach 402,549 and deaths to reach 259,304.

Ovarian cancer burden is increasing worldwide, with persistent and, in some settings, widening disparities.