Burden and trends of cancer and attributable risk factors in women, 1990 to 2023, with projections of mortality to 2050.

Abstract

e22624 Background: Cancer (CA) is a leading cause of premature mortality and disability in women worldwide. Women specific biological, hormonal, and reproductive factors intersect with rising exposure to metabolic and lifestyle risks—particularly in low- and middle-income countries (LMICs) to shape distinct CA patterns. However, global inequalities persist, and shifting risk profiles especially increasing metabolic exposures—underscore the need to track long-term trends in CA burden in women. Methods: This study applied the GBD 2023 analytical framework to quantify long-term trends in CA burden in women from 1990-2023 across 204 countries and territories. Using standardized GBD estimation pipelines, we evaluated deaths, disability-adjusted life years (DALYs), and incidence, stratified by CA type, Socio-demographic Index (SDI) region, attributable risk-factor, and age group. Temporal trends were summarized using estimated annual percent change (EAPC) derived from log-linear regression models. Future projections for cancer mortality were modeled through 2050. Results: From 1990-2023, global female CA deaths rose from 2.66 to 4.70 million (EAPC +1.55%); DALYs increased from 79.93 to 126.82 million (+1.19%); and incidence rose from 50.54 to 74.99 million (+1.25%). Prevalence counts increased across all SDI regions, with the steepest rise in Low SDI (+3.57%), followed by Low-middle SDI (+2.57%), Middle SDI (+2.19%), High-middle SDI (+1.37%), and High SDI (+1.33%). Age-standardized DALY rates declined across most cancers. However, other pharynx CA (+0.58%), lip and oral cavity CA (+0.26%), and non-melanoma skin CA (+0.07%) showed increasing trends. In contrast, the steepest declines were observed for stomach (−3.28%), esophageal (−2.36%), nasopharynx (−2.22%), Hodgkin lymphoma (−2.05%), and leukemia (−2.00%). Notably, breast (−0.31%), cervical (−0.63%), and liver CA (−0.91%) showed modest declines in age-standardized DALY rates. Across risk groups, age-standardized cancer DALY rates declined for all categories: Metabolic risks (EAPC −0.09%), Behavioral risks (−1.08%), Environmental/occupational risks (−1.32%). By age group, the largest DALY rate decline occurred in < 20 years (−1.71%), followed by ≥55 years (−1.04%), and 20–54 years (−0.39%). Incidence rates declined in < 20 years (−1.17%), 20–54 years (−0.51%), and were nearly stable in ≥55 years (−0.05%). Global CA deaths are projected to reach 6.62 million by 2050. Conclusions: Despite declining age-standardized DALY rates, the absolute burden of CA in women continues to rise, especially in low-SDI regions and younger age groups. While reductions in behavioral and environmental risk–related CA burden are encouraging, metabolic risks remain largely unchanged, calling for urgent, equity-driven investments in prevention, early detection, and risk-specific interventions.