The Global, Regional, and National Burden of Endometriosis in 204 Countries and Territories, 1990–2021: Results from the Global Burden of Disease Study 2021

Background :To analyze the prevalence and burden of disease (Disability-Adjusted Life Years) of endometriosis in 204 countries and regions from 1990 to 2021, and evaluate its global trends, regional differences and association with Socio-Demographic Index (SDI) and age distribution. Methods ：Data on the prevalence and Disability-Adjusted Life Years（DALYs）of endometriosis in 204 countries and regions from 1990 to 2021 were extracted using the the Global Burden of Disease（GBD）results tool (https://vizhub.healthdata.org/gbd-results/). Age-standardized rates, percentage changes in prevalence and DALYs, and 95% uncertainty intervals were calculated to quantify the overall disease burden. SDI was used to assess each country's development level. All statistical analyses were performed using R software (version 4.2.1). Result (s)：The global age standardised point prevalence and DALY rates for endometriosis were 26.2% and 26.1% lower than in 1990,respectively,with regional differences were significant.Oceania and Eastern Europe had the highest burden, while Western Europe and high-income Asia-Pacific regions had the lowest burden. The SDI exhibited a significant negative correlation with DALYs (R=-0.66, p<0.001). Countries with lower SDI(e.g., Niger and Chad)experienced a higher disease burden, whereas countries with higher SDI (e.g., Singapore and Switzerland)demonstrated a lower disease burden. Endometriosis is most prevalent among women aged 20-40 years, with the peak prevalence occurring in the 25-29 age group,and approaching zero prevalence in individuals over 55 years. Conclusion (s):Despite the decreasing burden of endometriosis from 1990 to 2021,significant differences remain across regions, countries, and age groups.Higher SDI are closely associated with lower disease burden, while reproductive age is a key factor influencing the prevalence of endometriosis.Future public health policies should focus more on the impact of endometriosis on reproductivehealth.Early detection and treatment should be prioritized to alleviate the effects of endometriosis on fertility and population structure, thus supporting the improvement of global women's health and social development.