title: Reasons for improved survival from ovarian cancer in New South Wales, Australia, between 1980 and 2003: implications for cancer control.
abstract: 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.
authors.affiliation: The Cancer Institute New South Wales, Australian Technology Park, Eveleigh PO Box 41, Alexandria, New South Wales 1435, Australia. Elizabeth.Tracey@cancerinstitute.org.au
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Tracey
authors.forename: David M
authors.initials: DM
authors.lastname: Roder
authors.forename: Jane
authors.initials: J
authors.lastname: Francis
authors.forename: Helen M
authors.initials: HM
authors.lastname: Zorbas
authors.forename: Neville F
authors.initials: NF
authors.lastname: Hacker
authors.forename: James F
authors.initials: JF
authors.lastname: Bishop
mesh_terms: 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