Global trends and predictions in ovarian cancer mortality.
Over the last two decades, ovarian cancer mortality rates have levelled or declined. There are, however, persisting and substantial differences in ovarian cancer patterns and trends.



We updated global trends in ovarian cancer mortality to 2012, and predicted trends in rates to 2020 using data from the World Health Organization database.



In the EU, age-adjusted ovarian cancer mortality rates decreased 10% between 2002 and 2012, to 5.2/100 000. The decline was ∼16% in the USA, to 4.9/100 000 in 2012. Latin American countries had lower rates, and declines were observed in Argentina and Chile. Likewise, modest declines (-2.1%) were observed in Japan, whose rate remained low (3.2/100 000 in 2012). Australia had a rate of 4.3/100 000 in 2012, and a 12% decline. The falls were larger in young women, than in middle or old age. Recent rates at age 20-49 were higher in Japan than in the EU and the USA. Predictions to 2020 indicate a further 15% decline in the USA and 10% in the EU and Japan.



The main reason for the favourable trends is the use of oral contraceptives (OCs), particularly, in the USA and countries of the EU where OCs were introduced earlier. Declines in menopausal hormone use may also have played a favourable role in elderly women, as well as improved diagnosis, management and treatment.
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.|Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan, Italy.
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Malvezzi
Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan, Italy.
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Carioli
Laboratorio Unificado del Complejo Hospitalario de Navarra, Pamplona, Spain.
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T
Rodriguez
Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan eva.negri@marionegri.it.
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E
Negri
Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan, Italy.
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La Vecchia
D001315:Australia; D005060:Europe; D005260:Female; D006801:Humans; D007564:Japan; D009026:Mortality / Q000639:trends*; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D014944:World Health Organization
diet; menopausal hormone replacement therapy; mortality; oral contraceptives; ovarian cancer; treatment