Global burden of ovarian cancer attributable to high BMI, 1990–2021: spatiotemporal trends, risk factors, frontier analysis, and projections to 2036 based on GBD 2021 study

Despite the well-established link between elevated body mass index (BMI) and ovarian cancer, comprehensive global assessments of the attributable burden remain scarce. Using the Global Burden of Disease (GBD) 2021 database, we quantified deaths and disability-adjusted life years (DALYs) from ovarian cancer due to high BMI between 1990 and 2021 and delineated spatiotemporal trends to inform targeted prevention. We analyzed GBD 2021 data for 204 countries and territories. Specifically, deaths and DALYs from ovarian cancer attributable to elevated BMI were quantified. Temporal trends were summarized with estimated annual percentage change (EAPC). Trends were examined with Joinpoint, decomposition, frontier, and predictive analyses. From 1990 to 2021, global deaths from ovarian cancer attributable to high BMI rose from 6,850 (95% UI 1,423–12,865) to 17,344 (4,141–30,810), a 153% increase; the age-standardized mortality rate (ASMR) grew by 17% to 0.38 per 100,000 (EAPC 0.40; 95% CI 0.32–0.47). Corresponding DALYs increased from 188,874 (38,401–355,691) to 477,248 (113,449–840,002), pushing the age-standardized DALY rate (ASDR) up 21% to 10.56 per 100,000 (EAPC 0.51; 0.45–0.57). Decomposition showed population growth contributed 57.58% of the net rise in deaths, ageing 25.26% and epidemiological change 17.16%. Only the high-SDI quintile exhibited declining rates; low- and middle-SDI regions sustained increases > 3% per year. Autoregressive Integrated Moving Average (ARIMA) model projections indicate both ASMR and ASDR will continue to climb until 2036. The BMI-attributable ovarian-cancer burden is rising, particularly among women aged 40–79 years, and urgently requires multisectoral fiscal, screening, and lifestyle interventions tailored to national SDI levels.