# Global Patterns and Temporal Trends in Ovarian and Uterine Cancer Mortality Attributable to High Body-Mass Index, 1990–2023

## TL;DR

This study shows that high BMI contributes significantly to ovarian and uterine cancer deaths globally, with rising trends especially during the COVID-19 pandemic.

## Contribution

The study quantifies the global mortality trends of ovarian and uterine cancers attributable to high BMI from 1990 to 2023, highlighting regional disparities and pandemic-era acceleration.

## Key findings

- Globally, 8.65% of ovarian cancer deaths and 33.33% of uterine cancer deaths in 2023 were attributable to high BMI.
- Mortality trends for both cancers attributable to high BMI increased significantly, with South Asia showing the fastest growth.
- An accelerated rise in mortality trends was observed during the 2020–2023 period, coinciding with the COVID-19 pandemic.

## Abstract

Although several risk factors for ovarian and uterine cancers are well-documented, these diseases still represent major public health concerns for women worldwide, and the full complexity of the drivers of global mortality trends requires further clarification. The main goal of this study was to evaluate global mortality of ovarian and uterine cancer attributable to high body-mass index (BMI) in 1990–2023. A total of 7.7 million deaths from ovarian and uterine cancer together were recorded worldwide (5.1 million ovarian cancer deaths and 2.6 million uterine cancer deaths) in the period observed. Globally, the fraction of deaths from ovarian cancer attributable to high BMI in 2023 was 8.65%, whereas for uterine cancer it reached 33.33%. From 1990 to 2023, global trends in mortality from both ovarian and uterine cancer attributable to high BMI increased significantly, with an accelerated growth during 2020–2023, a period which corresponds to the COVID-19 pandemic.

Background/Objectives: The risk factors for ovarian and uterine cancer remain insufficiently known. This study aimed to assess global trends in mortality from ovarian and uterine cancer attributable to high body-mass index (BMI) in 1990–2023. Methods: An observational epidemiological study was conducted. The age-standardized rates (ASRs) of mortality were retrieved from the Global Burden of Disease study. Trends were evaluated using joinpoint analysis. The Average Annual Percentage Change (AAPC, %), with a 95% Confidence Interval (CI), was calculated. Results: Globally, the trend in ASRs of ovarian cancer deaths attributable to high BMI increased significantly (AAPC = +0.4%, 95% CI = 0.3 to 0.5). The growth trend in South Asia (AAPC = +8.7%, 95% CI = 8.1 to 9.2) was 30 times greater than in Eastern Europe (AAPC = +0.3%, 95% CI = 0.1 to 0.5). Declining trends in mortality from ovarian cancer were observed only in Australasia (AAPC = −0.2%, 95% CI = −0.4 to −0.1), High-income North America (AAPC = −0.3%, 95% CI = −0.6 to −0.0), and Western Europe (AAPC = −0.7%, 95% CI = −0.8 to −0.6). For uterine cancer, the global trend of mortality also increased (AAPC = +0.1, 95% CI = 0.0 to 0.2), with the trend growing fastest in South Asia (AAPC = +4.2%, 95% CI = 4.0 to 4.4). Decreasing trends in mortality from uterine cancer due to high BMI were observed only in Central Asia (AAPC = −0.6%, 95% CI = −0.9 to −0.4), East Asia (AAPC = −2.2%, 95% CI = −2.6 to −1.8), and Southern Latin America (AAPC = −0.4%, 95% CI = −0.6 to −0.1). Additionally, an accelerated increase in mortality trends for both ovarian and uterine cancer attributable to high BMI was observed in 2020–2023, which corresponds to the period of the COVID-19 pandemic. Conclusions: Further analytical epidemiological studies are required to clarify the relationship between ovarian and uterine cancer and high BMI.