International patterns and trends in ovarian cancer incidence, overall and by histologic subtype

S B Coburn, F Bray, M E Sherman, B Trabert, S B Coburn, F Bray, M E Sherman, B Trabert

Abstract

Internationally, ovarian cancer is the 7th leading cancer diagnosis and 8th leading cause of cancer mortality among women. Ovarian cancer incidence varies by region, particularly when comparing high vs. low-income countries. Temporal changes in reproductive factors coupled with shifts in diagnostic criteria may have influenced incidence trends of ovarian cancer and relative rates by histologic subtype. Accordingly, we evaluated trends in ovarian cancer incidence overall (1973-1977 to 2003-2007) and by histologic subtype (1988-1992 to 2003-2007) using volumes IV-IX of the Cancer Incidence in Five Continents database (CI5plus) and CI5X (volume X) database. Annual percent changes were calculated for ovarian cancer incidence trends, and rates of histologic subtypes for individual countries were compared to overall international incidence. Ovarian cancer incidence rates were stable across regions, although there were notable increases in Eastern/Southern Europe (e.g., Poland: Annual Percent Change (APC) 1.6%, p = 0.02) and Asia (e.g., Japan: APC 1.7%, p = 0.01) and decreases in Northern Europe (e.g., Denmark: APC -0.7%, p = 0.01) and North America (e.g., US Whites: APC -0.9%, p < 0.01). Relative proportions of histologic subtypes were similar across countries, except for Asian nations, where clear cell and endometrioid carcinomas comprised a higher proportion of the rate and serous carcinomas comprised a lower proportion of the rate than the worldwide distribution. Geographic variation in temporal trends of ovarian cancer incidence and differences in the distribution of histologic subtype may be partially explained by reproductive and genetic factors. Thus, histology-specific ovarian cancer should continue to be monitored to further understand the etiology of this neoplasm.

Keywords: histologic subtype; incidence trends; international; ovarian cancer.

Conflict of interest statement

There are no conflicts of interest for the authors to report

© 2017 UICC.

Figures

Figure 1
Figure 1
Trends in age-adjusted ovarian cancer incidence rates per 100,000 woman-years by continent and country from 1973–1977 through 2003–2007, Cancer Incidence in Five Continents (CI5) volume IV–X
Figure 2
Figure 2
Annual Percent Change (APC) in age-adjusted ovarian cancer incidence rates from 1973–1977 through 2003–2007 by the age-adjusted rate in 2003–2007, Cancer Incidence in Five Continents (CI5)1 1Triangles represent populations in which the APC increased significantly (p<0.05), circles represent populations in which the APC increase or decrease was not statistically significant (p≥0.05), and the diamonds represent populations in which the APC decreased significantly across the time periods evaluated (p<0.05). 2Age-adjusted rate in 1998–2002
Figure 3
Figure 3
Proportion of the total epithelial ovarian cancer incidence rate by histologic subtype, Cancer Incidence in Five Continents (CI5) volume X, 2003–2007 1p<0.05, indicates that the proportion of the incidence rate contributed by the histologic subtype is statistically different from the corresponding international proportion (45% serous, 13% mucinous, 13% endometrioid, 6% clear cell, 24% other epithelial). Brazil 26% serous, 15% mucinous, 5% endometrioid, 1% clear cell and 53% other epithelial. Singapore 34% serous, 14% mucinous, 18% endometrioid, 21% clear cell and 14% other epithelial. Japan 28% serous, 16% mucinous, 14% endometrioid, 20% clear cell and 22% other epithelial. Thailand 23% serous, 16% mucinous, 14% endometrioid, 14% clear cell and 32% other epithelial. UK 46% serous, 26% mucinous, 13% endometrioid, 8% clear cell, 8% other epithelial. Finland 53% serous, 16% mucinous, 18% endometrioid, 6% clear cell, 7% other epithelial.
Figure 4
Figure 4
Trends and Annual Percent Change (APC) in age-adjusted ovarian cancer incidence rates per 100,000 woman-years by country and histology from 1988–1992 through 2003–2007, Cancer Incidence in Five Continents (CI5) volume VII–X
Figure 5
Figure 5
Age-specific incidence of ovarian cancer by histologic subtype, Cancer Incidence in Five Continents (CI5) volume X, 2003–2007

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