Female breast and gynecological cancers in Asia, 1990-2021: Burden and trends from the global burden of disease study

OBJECTIVE: Female breast and gynecological cancers (FeBGCs) are among the leading causes of cancer-related morbidity and mortality in women. However, updated and comparative evidences on their long-term burden and development-related disparities across Asia remain limited. This study examined the temporal trends, subregional heterogeneity, and socio-demographic index (SDI) related pattern of FeBGCs burden in Asia from 1990 to 2021. METHODS: Estimates of incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors for breast cancer (BC), cervical cancer (CC), ovarian cancer (OC), and uterine cancer (UC) were obtained from the Global Burden of Disease (GBD) (1990-2021) Study for 48 Asian countries. Epidemiological trends were analysed by age, year, location, risk factors, and socio-demographic index (SDI). RESULTS: In 2021, BC, CC, OC, and UC accounted for 10,335,176 (95% CI: 9280,423-11,485,400), 5318,838 (95% CI: 4733,230-5916,377), 2568,854 (95% CI: 2233,137-2992,341), and 1076,127 (95% CI: 889,739-1303,328) DALYs, respectively, reflecting increases of 1.59-fold, 0.31-fold, 1.48-fold, and 0.72-fold since 1990. BC burden peaked at ages 50-54, while CC, OC, and UC peaked at ages 55-59. Diverging from global trends, age-standardized incidence, mortality, and DALYs for BC and OC continued to rise in Asia, particularly in Western Asia. Within the GBD comparative risk assessment framework, high body mass index emerged as a major and rapidly increasing contributor to BC, OC, and UC burden. BC incidence showed a positive association with SDI, while CC burden consistently declined with increasing SDI, with notable deviations from SDI-expected levels across regions. CONCLUSIONS: Despite global improvements, the burden of breast and ovarian cancers continues to increase in Asia, underscoring substantial regional and development-related disparities. These findings highlight substantial regional heterogeneity in the burden of female breast and gynecological cancers across Asia. Within the context of GBD-based descriptive epidemiology and comparative risk assessment, the results support the need for region- and cancer-specific prevention and control strategies aligned with population aging, healthcare capacity, and major modifiable risk-factor profiles.