Estimated lifetime risks of major gynecologic cancers across 185 countries in 2022: life-course patterns and social inequalities

We compared lifetime incidence and mortality risks of cervical, ovarian, and endometrial cancers across 185 countries using GLOBOCAN 2022 estimates and United Nations World Population Prospects 2022 data. Lifetime incidence risk (LRI) and lifetime mortality risk (LRM) were estimated using life-table methods adjusted for competing mortality. Countries were stratified by income level and Human Development Index, and the LRI-to-LRM ratio was used as a descriptive measure of incidence-mortality divergence rather than a direct survival estimate. Cervical cancer showed the strongest inverse development gradient, with lifetime incidence ranging from 0.88% in high-income countries to 2.95% in low-income countries and mortality from 0.49% to 2.45%. Endometrial cancer showed the opposite pattern, with incidence reaching 2.73% in high-income countries versus 0.39% in low-income countries. Ovarian cancer showed relatively stable incidence but persistent mortality burden. The LRI-to-LRM ratio increased significantly with income for all three cancers, although this ecological measure is also influenced by diagnostic intensity, data quality, competing mortality, and health-system factors. Lifetime-risk metrics may complement age-standardized rates and help align prevention, early detection, and treatment priorities with country-specific health-system capacity.