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

Shiwen Zhang, Chen Cheng, Zejian Lin, Linzi Xiao, Xin Su, Lu Zheng, Yingjun Mu, Minqi Liao, Ruiqing Ouyang, Wanlin Li, Junrong Ma, Jun Cai, Lu Liu, Donghong Wang, Fangfang Zeng, Jun Liu, Shiwen Zhang, Chen Cheng, Zejian Lin, Linzi Xiao, Xin Su, Lu Zheng, Yingjun Mu, Minqi Liao, Ruiqing Ouyang, Wanlin Li, Junrong Ma, Jun Cai, Lu Liu, Donghong Wang, Fangfang Zeng, Jun Liu

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.

Keywords: Global burden of disease study 2019; Ovarian cancer; Risk factors.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Map of percentage change of incident cases due to ovarian cancer, 1990–2019
Fig. 2
Fig. 2
Incident cases (a), Deaths (b) and DALYs (c) of three age groups in different SDI regions in 2019
Fig. 3
Fig. 3
Map of age-standardized incidence rate due to ovarian cancer in 2019
Fig. 4
Fig. 4
Ranking changes in incident cases by country, 1990–2019
Fig. 5
Fig. 5
The correlation of ovarian cancer deaths and SDI, 1990–2019. The black line represents the average expected relation-ship between SDIs and deaths for ovarian cancer based on values from all countries from 1990 to 2019. SDI, social-demographic index
Fig. 6
Fig. 6
Ranking changes in number of deaths and DALYs by country, 1990–2019: (a) Number of DALYs; (b)Number of deaths
Fig. 7
Fig. 7
The ovarian cancer ASDR (a) and ASDALYR (b) attributable to risk factors between 1990 to 2019 by SDI regions. ASDR, age-standardized death rate; ASDALYR, age-standardized disability-adjusted life year rate

References

    1. Wild C, Weiderpass E, Stewart B. World cancer report 2020. Lyon: International Agency for Research on Cancer; 2020. pp. 199–512.
    1. Jayson GC, Kohn EC, Kitchener HC, Ledermann JA. Ovarian cancer. Lancet. 2014;384(9951):1376–1388. doi: 10.1016/S0140-6736(13)62146-7.
    1. Oberaigner W, Minicozzi P, Bielska-Lasota M, Allemani C, De Angelis R, Mangone L, et al. Survival for ovarian cancer in Europe: the across-country variation did not shrink in the past decade. Acta Oncol. 2012;51(4):441–453. doi: 10.3109/0284186X.2011.653437.
    1. Kim SJ, Rosen B, Fan I, Ivanova A, McLaughlin JR, Risch H, et al. Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer. Br J Cancer. 2017;116(7):964–971. doi: 10.1038/bjc.2017.35.
    1. Schulz M, Lahmann PH, Riboli E, Boeing H. Dietary determinants of epithelial ovarian cancer: a review of the epidemiologic literature. Nutr Cancer. 2004;50(2):120–140. doi: 10.1207/s15327914nc5002_2.
    1. Zhou Z, Wang X, Ren X, Zhou L, Wang N, Kang H. Disease Burden and Attributable Risk Factors of Ovarian Cancer From 1990 to 2017: Findings From the Global Burden of Disease Study 2017. Front Public Health. 2021;9:619581. doi: 10.3389/fpubh.2021.619581.
    1. Zheng L, Cui C, Shi O, Lu X, Li YK, Wang W, et al. Incidence and mortality of ovarian cancer at the global, regional, and national levels, 1990–2017. Gynecol Oncol. 2020;159(1):239–247. doi: 10.1016/j.ygyno.2020.07.008.
    1. Yang D, Huang H, Ruan T, Yang H, Hu J, Xu S, et al. Global, regional, and national burden of ovarian cancer and the attributable risk factors in all 194 countries and territories during 2007–2017: a systematic analysis of the Global Burden of Disease Study 2017. J Obstet Gynaecol Res. 2021;47(12):4389–4402. doi: 10.1111/jog.15019.
    1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol. 2020;76(25):2982–3021. doi: 10.1016/j.jacc.2020.11.010.
    1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–1222. doi: 10.1016/S0140-6736(20)30925-9.
    1. Stevens GA, Alkema L, Black RE, Boerma JT, Collins GS, Ezzati M, et al. Guidelines for accurate and transparent health estimates reporting: the GATHER statement. PLoS Med. 2016;13(6):e1002056. doi: 10.1371/journal.pmed.1002056.
    1. Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 2019;5(12):1749–1768. doi: 10.1001/jamaoncol.2019.2996.
    1. Murray CJ, Callender CS, Kulikoff XR, Srinivasan V, Abate D, Abate KH, et al. Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2018;392(10159):1995–2051. doi: 10.1016/S0140-6736(18)32278-5.
    1. Li X, Cao X, Guo M, Xie M, Liu X. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2020;368:m234. doi: 10.1136/bmj.m234.
    1. Ebrahimi H, Aryan Z, Moghaddam SS, Bisignano C, Rezaei S, Pishgar F, et al. Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Respir Med. 2021;9(9):1030–1049. doi: 10.1016/S2213-2600(21)00164-8.
    1. Moraga P, Collaborators GCoD. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390(10100):1151–1210.
    1. Wang H, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1084–1150. doi: 10.1016/S0140-6736(17)31833-0.
    1. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1789–1858. doi: 10.1016/S0140-6736(18)32279-7.
    1. Yao C, Wang Y, Wang L, Liu Y, Liu J, Qi J, et al. Burden of headache disorders in China, 1990–2017: findings from the global burden of disease study 2017. J Headache Pain. 2019;20(1):1–11. doi: 10.1186/s10194-019-1048-2.
    1. Hay SI, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1260–1344. doi: 10.1016/S0140-6736(17)32130-X.
    1. Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–1259. doi: 10.1016/S0140-6736(17)32154-2.
    1. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349(9063):1436–1442. doi: 10.1016/S0140-6736(96)07495-8.
    1. Murray CJ, Ezzati M, Lopez AD, Rodgers A, Vander HS. Comparative quantification of health risks: conceptual framework and methodological issues. Popul Health Metrics. 2003;1(1):1–20. doi: 10.1186/1478-7954-1-1.
    1. Collaborators G, Ärnlöv J. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–1249. doi: 10.1016/S0140-6736(20)30752-2.
    1. Jiang YT, Gong TT, Zhang JY, Li XQ, Gao S, Zhao YH, et al. Infertility and ovarian cancer risk: Evidence from nine prospective cohort studies. Int J Cancer. 2020;147(8):2121–2130. doi: 10.1002/ijc.33012.
    1. Babic A, Sasamoto N, Rosner BA, Tworoger SS, Jordan SJ, Risch HA, et al. Association Between Breastfeeding and Ovarian Cancer Risk. JAMA Oncol. 2020;6(6):e200421. doi: 10.1001/jamaoncol.2020.0421.
    1. Michaan N, Park SY, Won YJ, Lim MC. Comparison of gynecologic cancer risk factors, incidence and mortality trends between South Korea and Israel, 1999–2013. Jpn J Clin Oncol. 2018;48(10):884–891. doi: 10.1093/jjco/hyy111.
    1. George SHL, Donenberg T, Alexis C, DeGennaro V, Jr, Dyer H, Yin S, et al. Gene Sequencing for Pathogenic Variants Among Adults With Breast and Ovarian Cancer in the Caribbean. JAMA Netw Open. 2021;4(3):e210307. doi: 10.1001/jamanetworkopen.2021.0307.
    1. Deng F, Xu X, Lv M, Ren B, Wang Y, Guo W, et al. Age is associated with prognosis in serous ovarian carcinoma. J Ovarian Res. 2017;10(1):36. doi: 10.1186/s13048-017-0331-6.
    1. Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, et al. The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2) Gynecol Oncol. 2017;144(2):405–413. doi: 10.1016/j.ygyno.2016.10.019.
    1. Tew WP. Ovarian cancer in the older woman. J Geriatr Oncol. 2016;7(5):354–361. doi: 10.1016/j.jgo.2016.07.008.
    1. van Nagell JR Jr, Burgess BT, Miller RW, et al. Survival of Women With Type I and II Epithelial Ovarian Cancer Detected by Ultrasound Screening. Obstet Gynecol. 2018;132(5):1091–100.
    1. Menon U, Gentry-Maharaj A, Burnell M, Singh N, Ryan A, Karpinskyj C, et al. Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. The Lancet. 2021;397(10290):2182–2193. doi: 10.1016/S0140-6736(21)00731-5.
    1. Cohen DH, LeRoith D. Obesity, type 2 diabetes, and cancer: the insulin and IGF connection. Endocr Relat Cancer. 2012;19(5):F27–F45. doi: 10.1530/ERC-11-0374.
    1. Bakhru A, Buckanovich RJ, Griggs JJ. The impact of diabetes on survival in women with ovarian cancer. Gynecol Oncol. 2011;121(1):106–111. doi: 10.1016/j.ygyno.2010.12.329.
    1. Goodall R, Alazawi A, Hughes W, Bravis V, Salciccioli JD, Marshall DC, et al. Trends in type 2 diabetes mellitus disease burden in European Union countries between 1990 and 2019. Sci Rep. 2021;11(1):1–14. doi: 10.1038/s41598-021-94807-z.
    1. Khamseh ME, Sepanlou SG, Hashemi-Madani N, et al. Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study. Diabetes Ther. 2021;12(11):2921–38.
    1. Kotwas A, Karakiewicz B, Zabielska P, Wieder-Huszla S, Jurczak A. Epidemiological factors for type 2 diabetes mellitus: evidence from the Global Burden of Disease. Arch Public Health. 2021;79(1):1–7. doi: 10.1186/s13690-021-00632-1.
    1. Yang H, Bocchetta M, Kroczynska B, Elmishad AG, Chen Y, Liu Z, et al. TNF-α inhibits asbestos-induced cytotoxicity via a NF-κB-dependent pathway, a possible mechanism for asbestos-induced oncogenesis. Proc Natl Acad Sci. 2006;103(27):10397–10402. doi: 10.1073/pnas.0604008103.
    1. Kameda T, Takahashi K, Kim R, Jiang Y, Movahed M, Park E-K, et al. Asbestos: use, bans and disease burden in Europe. Bull World Health Organ. 2014;92:790–797. doi: 10.2471/BLT.13.132118.
    1. Furuya S, Chimed-Ochir O, Takahashi K, David A, Takala J. Global asbestos disaster. Int J Environ Res Public Health. 2018;15(5):1000. doi: 10.3390/ijerph15051000.
    1. Arthur R, Brasky TM, Crane TE, Felix AS, Kaunitz AM, Shadyab AH, et al. Associations of a healthy lifestyle index with the risks of endometrial and ovarian cancer among women in the Women’s Health Initiative Study. Am J Epidemiol. 2019;188(2):261–273. doi: 10.1093/aje/kwy249.
    1. Li Cl, Jiang M, Pan CQ, Li J, Xu LG. The global, regional, and national burden of acute pancreatitis in 204 countries and territories, 1990–2019. BMC Gastroenterol 2021;21(1):1–12.

Source: PubMed

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