Burden and Risk Factor Patterns of Reproductive System Tumors and Non-Tumor Diseases Among Asian Women, 1990-2021: Evidence from the GBD Study.

Background: Female reproductive system diseases, including malignant tumors such as breast, ovarian, and uterine cancers, and non-neoplastic disorders such as uterine fibroids, endometriosis, polycystic ovary syndrome (PCOS), infertility, and premenstrual syndrome (PMS), represent major health challenges in Asia. While malignant diseases receive considerable attention due to high mortality, the long-term burden of non-malignant conditions affecting fertility, psychological well-being, and quality of life remains underestimated. Methods: Data from the Global Burden of Disease (GBD) 2021 were used to quantify the burden of female reproductive system diseases in 47 Asian countries and territories from 1990 to 2021. Incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were analyzed, together with age-standardized rates. Temporal trends were assessed using estimated annual percentage change (EAPC), and disease burden patterns were examined across Socio-demographic Index (SDI) levels. Associations between major modifiable risk factors and disease burden were described. Results: In 2021, female reproductive system diseases accounted for over 33 million DALYs and approximately 600,000 deaths in Asia. Breast and cervical cancers were the leading contributors to mortality and DALYs, whereas PMS and infertility accounted for a substantial burden among younger women. From 1990 to 2021, absolute case numbers and deaths increased with population growth and aging, while most age-standardized rates declined, particularly for cervical cancer. In contrast, PCOS and infertility showed the fastest increases. High body mass index and elevated fasting glucose were strongly associated with breast and uterine cancer burden, while smoking was closely associated with cervical cancer burden. Conclusion: Female reproductive system diseases impose a substantial and heterogeneous burden across Asia. Although malignant cancers remain the main contributors to mortality and DALYs, non-malignant disorders increasingly affect reproductive health, particularly among younger women. Prevention strategies tailored to SDI levels and major risk factors are needed to reduce the overall disease burden across the region.