Vol. 2 No. 6 (2025)

Research Articles

The Global Burden and Causal Associations of Risk Factors with Ovarian Cancer: A Combined GBD and Mendelian Randomization Analysis

Published 2025-11-30

  • Lisa Sun
    • ,
  • Yongwen Yang
    • ,
  • Haoming Shen
    • ,
  • Bin Qu

Lisa Sun
Central South University image/svg+xml , Hunan Cancer Hospital image/svg+xml

Yongwen Yang
Xiangya Hospital Central South University image/svg+xml

Haoming Shen
Xiangya Hospital Central South University image/svg+xml

Bin Qu
Xiangya Hospital Central South University image/svg+xml

Abstract

Ovarian cancer (OC) remains a major cause of gynecologic cancer mortality worldwide, with incidence continuing to rise in low- and middle-SDI regions. Metabolic risk factors may be reshaping OC epidemiology. This study quantifies global OC burden from 1990 to 2023 and examines causal relationships between metabolic and behavioral factors and OC using Mendelian randomization (MR). Using GBD 2023 data, we assessed OC incidence, mortality, DALYs, and estimated annual percentage changes (EAPCs) across regions and SDI levels. A two-sample MR analysis was conducted to evaluate causal effects of multiple exposures, with sensitivity tests including MR-Egger, weighted median, and Cochran’s Q. From 1990 to 2023, global OC incidence increased by 111%, deaths by 100.7%, and DALYs by 97.4%. Age-standardized incidence and mortality rates declined until 2014 but have risen over the past decade, particularly in low- and middle-SDI settings. Women aged 30–49 years experienced the fastest growth in EAPC. MR results indicated significant associations between OC risk and HIP (OR = 1.29, 95% CI: 1.13–1.48), childhood BMI (OR = 1.22, 95% CI: 1.07–1.39), and waist circumference (OR = 1.28, 95% CI: 1.07–1.51), with consistent findings across sensitivity analyses and no evidence of pleiotropy. These results indicate a rising global OC burden and support a causal link between central adiposity, early-life obesity, and OC risk, emphasizing the need for targeted metabolic interventions and early detection strategies.

Keywords

Ovarian cancer, Global Burden of Disease, Mendelian randomization, obesity, waist circumference, childhood body mass index

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