Global trends and socio-demographic inequalities in the burden of genital neoplasms: a 30-year comprehensive analysis of the Global Burden of Disease Study 2021

Background While global longevity increases, economic disparities drive unequal burdens of genital neoplasms. This first comprehensive study evaluates how Socio-demographic Index (SDI) shapes the epidemiology of six major genital neoplasms (uterine fibroids [UFs], prostate [PC], cervical [CC], uterine [UC], testicular [TC], and ovarian cancer [OC]), providing evidence for equitable resource allocation. Methods Using 2021 Global Burden of Disease data (1990-2021), we analyzed age-standardized rates (ASRs) of incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) (ASDR) across 204 countries, stratified by SDI quintiles, age, and region. Trend analysis employed estimated annual percentage changes (EAPCs). Inequality was quantified via slope/concentration indices (SII/CI). Age-period-cohort modeling identified risk transitions. Results There are notable disparities in the burden of genital neoplasms by cancer type. UFs showed the highest global prevalence (ASPR 2,841.07/100,000), while PC dominated mortality (ASMR 12.63/100,000). Divergent trends emerged: CC burden declined (DALYs -31.45%, 1990-2021) but rose for TC (ASPR EAPC 1.80%). High-SDI regions had 3.2-fold higher PC incidence yet 67% lower CC mortality than low-SDI areas. SDI-driven inequalities narrowed for UC (SII Δ-12.46) but persisted for PC (CI crossed zero). Projections suggest rising UFs cases (+15.98% by 2035) despite stable ASRs, highlighting demographic pressures. Conclusions SDI-mediated disparities require targeted interventions, particularly CC screening in low-resource settings and TC/PC prevention in high-income regions. Limitations include underdiagnosis in low-SDI areas. These findings establish a framework for global cancer control prioritization.