Global burden of cancer in women, 1990–2021: a systematic analysis from the GBD 2021 study

Abstract

Objective: This study evaluates global burden, disparities, and trends of female cancers (breast, cervical, uterine, ovarian) from 1990 to 2021, and identifies key contributing factors and intervention strategies. Methods: Data from the Global Burden of Disease (GBD,1990–2021) Study and recent reports were analyzed to assess incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries stratified by Socio-demographic Index (SDI). Regression and spatiotemporal analyses explored links with risk factors (e.g., obesity, HPV) and healthcare access. Results: Breast cancer dominated the burden, with age-standardized incidence rates (ASIR) rising by 28% (2.08 million new cases in 2021), driven by lifestyle factors (high BMI, alcohol use) and showing a strong connection with higher SDI (r=0.82). Cervical cancer remained a critical challenge in low- and middle-income regions, showing a strong negative correlation with SDI(r = -0.75), though Age-Standardized Mortality Rate (ASMR) declined globally (-1.4% annual change). Uterine cancer incidence rose steadily (0.7% annual increase; 473,614 cases in 2021), primarily attributable to obesity, while ovarian cancer mortality remained high (207,000 deaths) due to late diagnosis. Key modifiable risks included HPV infection (85% of cervical cancers), tobacco use, and reproductive behaviors. Conclusion: The global burden of female cancers presents a significant public health challenge. Disparities in female cancer burden reflect inequities in healthcare access and rising metabolic risks. Priority actions include HPV vaccination, low-cost screening, and obesity control. Equity-focused, data-informed policies are crucial to reduce global disparities.