Female cancers in adolescent and young adult women: global inequities and 2050 burden estimates from GLOBOCAN 2022.
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OBJECTIVES: To quantify the global, regional, and national burden of six major female cancers among adolescent and young adult (AYA) women (aged 15-39 years) in 2022, and to project incidence and mortality trends to 2050. METHODS: Using GLOBOCAN 2022 estimates, we analyzed incidence, mortality, age-standardized rates, cumulative risk, and mortality-to-incidence ratios (MIRs) for breast, ovarian, corpus uteri, cervical, vaginal, and vulvar cancers across 185 countries. Burden metrics were compared across geographic regions and Human Development Index (HDI) categories. Spearman correlation analyses assessed associations between HDI and cancer burden indicators. Future cancer burden through 2050 was projected based on global demographic forecasts, assuming constant 2022 age-specific incidence and mortality rates. RESULTS: Globally, an estimated 406,385 incident cases and 93,848 deaths from female cancers occurred among AYA women in 2022, corresponding to an ASIR of 24.8 and an ASMR of 5.7 per 100,000 population. Breast cancer accounted for the largest burden of both incident cases and deaths, whereas cervical cancer exhibited the highest mortality-to-incidence ratio, indicating disproportionately poor survival. Considerable geographic and socioeconomic disparities were observed. Very high-HDI countries had the highest incidence but the lowest mortality, whereas low-HDI countries experienced disproportionately high mortality and the highest MIR. HDI was positively associated with incidence (ASIR: ρ = 0.282; cumulative incidence: ρ = 0.302; both P < 0.001) but strongly inversely associated with mortality (ASMR: ρ = -0.797; cumulative mortality: ρ = -0.795) and MIR (ρ = -0.900; all P < 0.001). Assuming constant age-specific rates, incident cases are projected to increase by 13.7% and deaths by 27.7% globally by 2050, with the largest increases expected in Africa and low-HDI countries. CONCLUSIONS: Female cancers impose a substantial and inequitable burden among AYA women worldwide. The projected increase in burden, particularly in low-HDI countries, highlights the urgent need to strengthen equitable cancer prevention, early detection, and treatment to reduce global disparities.