Long-term trends and projections of ovarian cancer burden in China (1990 to 2040): an age-period-cohort analysis based on GBD 2021 data.

Background: The growing burden of ovarian cancer is attracting widespread attention; the impact factors and the evolution trend of ovarian cancer burden need to be further studied. Methods: Ovarian cancer disease burden data for Chinese women were obtained from the Global Burden of Disease study 2021. We performed Age-Period-Cohort (APC) analysis to evaluate evolution trends across age, period, and cohort dimensions and identify contributing factors. Using the Bayesian Age-Period-Cohort (BAPC) model, we projected incidence and mortality trends through 2040. Results: In 2021, China recorded approximately 41,240 new ovarian cancer cases and 25,140 related deaths. From 1990 to 2021, age-standardized rates (ASRs) for incidence, mortality, and disability-adjusted life years fluctuated but increased steadily after 2015, with annual percentage changes of 1.6% (95%CI: 1.4%, 1.8%), 1.6% (95%CI: 1.4%, 1.9%), and 1.5% (95%CI: 1.3%, 1.6%), respectively. The APC model revealed a significant age effect with peak incidence occurring at 65-69 years; a period effect showing incidence and mortality rates resurged after 2015; and the cohort effects demonstrating bimodal incidence peaks in the birth cohorts of 1910-1914 and 1935-1939. Specifically, a 1% increase in the obesity rate was associated with a 3.06 (95%CI: 0.84, 5.28; Conclusions: The burden of ovarian cancer in China remains significant; the increasing obesity rate in women may be a driver. The ovarian cancer burden has resurged in China since 2015, and it is projected to continue increasing by 2040.