Recent Trends in Ovarian Cancer Incidence and Relative Survival in the United States by Race/Ethnicity and Histologic Subtypes

Abstract

Background: Incidence and survival rates of nonserous epithelial ovarian cancer in racial/ethnic minorities remain relatively unknown in the United States. We examined the trends in incidence and survival rates for epithelial ovarian cancer by histologic subtypes and race/ethnicity.Methods: Ovarian cancer incidence and mortality data from 2000 to 2013 were obtained from the Surveillance, Epidemiology, and End Results database. Age-adjusted incidence rate, incidence rate ratio, and annual percentage changes (APC) were calculated by histology and race/ethnicity subgroups and stratified by age at diagnosis. Five-year relative survival rates were calculated by stage and race/ethnicity.Results: A small but significant decrease in incidence rates was seen in non-Hispanic white (NHW), non-Hispanic black (NHB), and Hispanic women (APC -1.58, -0.84, and -1.31, respectively), while incidence rates remained relatively stable in Asian women (APC -0.37). With exception of significant increase in the incidence rate of clear cell carcinoma among Asian woman (APC 1.85), an overall trend toward decreasing incidence rates was seen across histologic subtypes and age-strata, although not all results were statistically significant. Compared with NHW women, NHB women experienced poorer 5-year survival at every stage across histologic subtypes, while Hispanic and Asian women had equivalent or better survival.Conclusions: Over the last decade, incidence rates of epithelial ovarian cancer in the United States have decreased or remained stable across race/ethnic and histologic subgroups, except for clear cell carcinoma. Survival remains poorest among NHB women.Impact: Comparative histologic subtype distribution and incidence trends do not explain the ovarian cancer survival disparity disproportionately affecting NHB women. Cancer Epidemiol Biomarkers Prev; 26(10); 1511-8. ©2017 AACR.

Figure 1.

APC of age-adjusted incidence rates of ovarian and fallopian tube cancer by histology subtype and race, SEER, 2000 to 2013. *, Statistically significant APC (P < 0.05). ^aInclude mixed, other, undifferentiated, unspecified carcinoma. Abbreviation: NOS, not otherwise specified.

Figure 2.

APC of age-adjusted incidence rates of ovarian and fallopian tube cancer by age-group and race, SEER, 2000 to 2013. *, Statistically significant APC (P < 0.05).

Figure 3.

Five-year survival by histology subtype, race, and stage for ovarian and fallopian tube cancer diagnosed from 2000 to 2009, SEER. A, All types. B, Serous. C, Clear cell, endometrioid, and mucinous. *, Statistically significant difference (P < 0.05) in relative survival compared with NHW women.