Comparative Assessment of Gynecologic Cancer Trends in Turkey: A Nationwide Analysis

Background: Gynecologic cancers constitute a major public health burden worldwide, with marked regional and temporal variations influenced by demographic changes, healthcare access, and screening practices. In Turkey, contemporary nationwide data capturing recent temporal trends—particularly during the COVID-19 pandemic—remain limited. Methods: This nationwide, retrospective observational study integrated six independent gynecologic cancer datasets obtained from the İstinye University Dataset Sharing Platform, comprising 22,468 adult patients (≥18 years) diagnosed between 2014 and 2024 across 33 hospitals in Turkey. Cancer types included ovarian, endometrial, cervical, vulvar, vaginal, and fallopian tube malignancies. Annual case counts were analyzed, and normalized admission rates were calculated per 100,000 unique patient admissions to account for variations in healthcare utilization. Cancer-type–specific analyses and descriptive pandemic-period sensitivity analyses were performed. Results: The mean age of the study population was 62.75 ± 13.95 years, with most patients aged over 60 years (60.9%). Ovarian cancer was the most frequent diagnosis (40.8%), followed by endometrial (34.7%) and cervical cancers (20.7%), while rarer malignancies accounted for less than 4% of cases. Annual diagnoses increased progressively from 2014 to 2019, followed by a marked rise in 2020 and a pronounced peak in 2021, during which 30.6% of all cases were recorded. When normalized to total unique patient admissions, gynecologic cancer admission rates ranged from 45.2–55.1 per 100,000 in the pre-pandemic period and peaked sharply in 2021 at 239.1 per 100,000 admissions. Cancer-type–specific normalization revealed parallel temporal patterns across all malignancies, with the most pronounced increases observed for ovarian (104.1 per 100,000) and endometrial cancers (77.4 per 100,000) in 2021. Overall mortality was 2.8%, with a mean survival of 13.13 ± 17.79 months among exitus patients, and no significant differences in survival duration across cancer types. Conclusions: This nationwide multicenter analysis demonstrates a substantial increase in gynecologic cancer presentations in Turkey over the past decade, with a pronounced, system-wide surge during the COVID-19 pandemic period. Normalized analyses indicate that this increase exceeded overall healthcare utilization, suggesting pandemic-related diagnostic delays and backlog effects. Continuous surveillance using utilization-adjusted metrics is essential to accurately interpret temporal trends and to guide future cancer control and healthcare resilience strategies.