Epidemiology

The incidence of ovarian cancer increases with age. Epithelial ovarian cancer is predominantly a disease of perimenopausal and postmenopausal women, with 80% of ovarian cancers occurring after age 40. Based on the cancer registry data collected by the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute, the median age at diagnosis for cancer of the ovary is 63 years. Age-specific incidence analysis reveals the following percentages of age at diagnosis of ovarian cancer:

1.2%—20 years 3.5%—20 to 34 years 8.1%—35 to 44 years 18.6%—45 to 54 years

21.4%—55 to 64 years 20.8%—65 to 74 years 19.4%—75 to 84 years 7.0%—>85 years

Figure 1-1. Cancer death rates for women, United States, 1930-2005 (per 100,000 women). Rates are age-adjusted to the 2000 U.S. standard population. (From US Mortality Public Use Data Tapes, 1960-2005, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2008. American Cancer Society, Cancer Facts & Figures 2009. Atlanta: American Cancer Society, Inc., 2009.)

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Figure 1-1. Cancer death rates for women, United States, 1930-2005 (per 100,000 women). Rates are age-adjusted to the 2000 U.S. standard population. (From US Mortality Public Use Data Tapes, 1960-2005, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2008. American Cancer Society, Cancer Facts & Figures 2009. Atlanta: American Cancer Society, Inc., 2009.)

Table 1-1. Lifetime Probability of Developing Cancer by Site in Women, United States, 2002-2004*

Site Risk

All sites1 1 in 3

Breast 1 in 8

Lung and bronchus 1 in 16

Colon and rectum 1 in 20

Uterine corpus 1 in 40

Non-Hodgkin lymphoma 1 in 53

Melanoma® 1 in 58

Ovary 1 in 72

Pancreas 1 in 75

Urinary bladder* 1 in 84

Uterine cervix 1 in 145

*For those free of cancer at beginning of age interval.

A sites exciude basai and squamous ceii skin cancers and in situ cancers except urinary bladder. tinciudes invasive and in situ cancer cases. §Statistic for white women.

From DevCan: Probabiiity of Deveioping or Dying of Cancer Software, Version 6.2 Statisticai Research and Appiications Branch, NCi, 2007, http://srab.cancer.gov/devcan. Copyright 2009 American Cancer Society, inc. Reprinted with permission. Aii rights reserved.

Table 1-2. Incidence Rates by Race

Race/Ethnicity Incidence

All races 13.3 per 100,000 women

White 14.1 per 100,000 women

Black 10.1 per 100,000 women

Asian/Pacific Islander 9.8 per 100,000 women

American Indian/Alaska native 11.3 per 100,000 women

Hispanic 11.7 per 100,000 women

Data from Ries LAG, Harkins D, Krapcho M, et al: (eds): SEER Cancer Statistics Review, 1975-2005, National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER web site 2008. http://www.seer.cancer.gov/

Women with ovarian cancer and age younger than 50 have a 5-year survival rate of 70.5% compared with 40.6% in those 50 or older.3 Survival is related to stage at diagnosis. In recent studies of the Gynecologic Oncology Group (GOG), the progression-free survival after platinum-paclitaxel chemotherapy following optimal cytoreduction was 21 to 22 months, and the median overall survival was 52 to 57 months.4,5

The average incidence of ovarian cancer in African-American women is 10.1 per 100,000 women compared with 14.5 per 100, 000 white women.1 However African-American women have poorer survival rates compared with whites regardless of socioeconomic status.6 A review of cases of epithelial ovarian cancer submitted to the National Cancer Database between 1985 and 1988 and between 1990 and 1993 revealed that African-American women were two times more likely than white women not to receive appropriate treatment. They had poorer survival rates than white women from the same or different hospitals, regardless of income. Among staged cases, African-American women were more often diagnosed with stage IV disease than were white women. The incidence rates by race are shown in Table 1-2. The majority of ovarian cancers are sporadic. The overall risk of developing ovarian cancer for women in the United States is 1.0% to 1.8%. For women with family history of ovarian cancer, the risk increases to 9.4%.7

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