Rising Ovarian Cancer Burden in Africa, 2009–2023: Epidemiological Change, Age-Specific Patterns, COVID-19-Related Deviations, and Future Forecasts
TL;DR
GBD 2023 estimates indicate a rising ovarian cancer burden among women in Africa, with substantial geographical and age-specific heterogeneity, and possible further ASR increases through 2040, with widening prediction intervals.
Abstract
Background Ovarian cancer is an important cause of cancer morbidity and mortality among women, but continent-wide evidence from Africa remains limited. We used Global Burden of Disease (GBD) 2023 estimates to assess ovarian cancer burden among African females from 2009 to 2023. Methods We conducted a population-level ecological analysis of GBD 2023 estimates for 54 African countries. We assessed incidence, prevalence, deaths, disability-adjusted life-years (DALYs), age-standardised rates (ASRs), temporal trends, Socio-demographic Index (SDI) correlations, Das Gupta decomposition, age-specific patterns, COVID-19-period deviations, and exploratory autoregressive integrated moving average (ARIMA) projections to 2040. Results Between 2009 and 2023, incident cases increased from 14,582 to 40,884, deaths from 9,099 to 24,123, and DALYs from 338,844 to 919,069. Nigeria had the largest absolute burden in 2023, whereas the highest ASRs were concentrated mainly in eastern and central sub-Saharan Africa. SDI was not significantly associated with 2023 ASRs, and inverse associations between SDI and temporal increases were weak and nonsignificant. Decomposition attributed the largest share of the increase in absolute burden to the rate-related component, with additional contributions from population growth and ageing. Age-specific incidence and mortality generally increased with age and peaked in older age groups. During 2020–2023, observed burden exceeded counterfactual estimates overall after a below-expected pattern in 2020. Exploratory ARIMA projections suggested possible further ASR increases through 2040, with widening prediction intervals. Conclusion GBD 2023 estimates indicate a rising ovarian cancer burden among women in Africa, with substantial geographical and age-specific heterogeneity. Strengthening cancer surveillance, diagnosis, pathology, surgery, and access to systemic treatment is needed.