Reasons for improved survival from ovarian cancer in New South Wales, Australia, between 1980 and 2003: implications for cancer control.
We analyzed New South Wales Central Cancer Registry data for 1980-2003, to determine time trends in case fatality from ovarian cancer, after adjusting for stage, histological, and sociodemographic factors, and to consider service-delivery and research implications. After adjusting for covariates, the relative risk (95% confidence limit) of ovarian-cancer death reduced to 0.51 (0.46, 0.57) for 1999-2003 compared with 1980-1983. Relative risks were higher for adenocarcinomas and other specified and unspecified cancers than serous carcinomas, but lower for endometrioid carcinomas, sex cord-stromal and germ cell tumors. The probability of diagnosis with localized as opposed to more advanced disease was lower in older patients, the lowest socioeconomic stratum, women born in non-English-speaking countries, and more recent diagnostic periods. Approximately 61% of ovarian cancers had distant metastases at diagnosis in 1999-2003. Poorer survivals apply to older patients. Research directed at finding an effective screening test for epithelial ovarian cancer remains a priority.
Tracey
Elizabeth A
EA
The Cancer Institute New South Wales, Australian Technology Park, Eveleigh PO Box 41, Alexandria, New South Wales 1435, Australia. Elizabeth.Tracey@cancerinstitute.org.au
Roder
David M
DM
Francis
Jane
J
Zorbas
Helen M
HM
Hacker
Neville F
NF
Bishop
James F
JF
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D009517:New South Wales / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012042:Registries; D012959:Socioeconomic Factors