Global Trends in Polycystic Ovarian Syndrome Over 30 Years: An Age-Period-Cohort Study of 204 Countries and Territories (1990- 2021)

Abstract Objective Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women globally, with significant increases in incidence over the past three decades. Despite the rising prevalence, limited data exist on the global incidence trends of PCOS, especially across diverse socio-demographic contexts. Methods This study analyzed PCOS incidence trends from 1990 to 2021 across 204 countries using an age-period-cohort (APC) analysis. Data were sourced from the Global Burden of Disease Study 2021, focusing on crude and age-standardized incidence rates, disaggregated by region and socio-demographic index (SDI). Results The global incidence of PCOS increased from 1.48 million cases in 1990 to 2.3 million in 2021. The age-standardized incidence rate in 2021 was 63.26 per 100,000 population (95% CI: 45.41 to 87.28). High SDI regions recorded the highest incidence rates, with a rate of 90.13 per 100,000 (95% CI: 66.94 to 122.36). In contrast, low SDI regions had the lowest incidence rates at 36.8 per 100,000 (95% CI: 25.83 to 52.19). The APC model revealed a global net drift of 0.18 (95% CI: -0.02 to 0.37), with significant age and period effects, particularly among younger age groups. Conclusion The study underscores a significant global rise in PCOS incidence, particularly in high SDI regions and among younger age groups. These findings highlight the need for targeted public health interventions and further research to address the growing burden of PCOS.