Global trends in early-onset uterine cancer and the rising BMI-attributable burden: A population-based analysis, 1990–2023.

Abstract

e17644 Background: Uterine cancer incidence has increased globally over recent decades, with growing concern regarding rising diagnoses among younger individuals. Obesity is a well-established risk factor for uterine cancer and may contribute to disease burden at earlier ages. However, global trends in early-onset uterine cancer incidence and the BMI-attributable burden have not been comprehensively characterized. Methods: We analyzed uterine cancer incidence and BMI-attributable disability-adjusted life year (DALY) rates using Global Burden of Disease 2023 estimates from 1990–2023 among individuals aged 15–49 years. Rates per 100,000 population were evaluated globally, by Socio-Demographic Index (SDI), and at the country level. Temporal trends were assessed using log-linear regression to estimate average annual percent change (APC) with 95% confidence intervals. Results: Between 1990 and 2023, an estimated 1,885,159 incident cases of uterine cancer occurred globally, with annual cases increasing from 35,102 in 1990 to 74,790 in 2023. Among individuals aged 15-49 years, incidence rates demonstrated a sustained upward trend over the study period. Globally, incidence rates increased from 3.56 in 1990 to 4.21 in 2023, corresponding to an APC of 0.15% (95% CI, 0.01%–0.28%). Substantial heterogeneity was observed across SDI regions, with High SDI regions consistently exhibiting the highest incidence rates, while low and middle SDI regions showed gradual increases over time. In 2023, the highest incidence rates were observed in Northern Mariana Islands (15.7), Barbados (14.6), and Bahamas (13.1). BMI-attributable DALY rates increased numerically from 8.05 to 10.0 between 1990 and 2023 (APC 0.14%; 95% CI, −0.07% to 0.34%). The highest BMI-attributable burdens in 2023 were observed in Nauru (98.7), Micronesia (68.7), and Guyana (65.0). Conclusions: Uterine cancer incidence among individuals aged 15–49 years has increased globally over the past three decades, alongside a numerically increasing BMI-attributable burden, suggesting a need for targeted interventions including obesity-focused strategies in younger populations.