Mortality from ovarian cancer in women of the United States: A 21-year analysis of trends and disparities.

Abstract

e17551 Background: In the United States, Ovarian cancer ranks 2nd most common gynecological cancer and causes the highest mortality among all the cancers of female reproductive tract. We aim to examine temporal trends of malignant neoplasm of ovary-related deaths in the United States from 1999-2020. Methods: Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database were examined from 1999 to 2020. The data was extracted using ICD-10 code C56 from multiple causes of death database using the female only filter and stratified by race/ethnicity, age groups, place of death, regions and urbanization. Temporal trends were described by calculating Age Adjusted Mortality Rates (AAMR) per 100,000 with 95% Confidence Intervals (CI) and Annual Percent Changes (APC) using Jointpoint regression analysis. Results: Between 1999-2020, a total of 338,215 women died as a result of Ovarian Cancer. The age adjusted mortality rate (AAMR) was 9.48 in 1999 and it increased slightly till 2003 (APC: 0.41; 95% CI: -0.54 to 1.86). Afterwards it declined to 6.55 in 2020 (APC: -2.28; 95% CI: -2.41 to -2.16). Significant racial disparities were noted. The highest AAMR of 8.64 was observed in Non-Hispanic (NH) White, followed by NH Black or African Americans (7.08), NH American Indians/Alaska Natives (5.31), and lowest AAMR of 4.96 was observed in NH Asian or Pacific Islanders. AAMRs showed minimal variations by census region, however, highest AAMR was observed in Northeast region (8.55). Age group stratification also revealed that Age group of 65+years had the highest AAMR at 43.09 followed by 45-64 years (11.25) age group and 25-44 years age group (1.20). AAMR in both Metropolitan (8.31) and Non-metropolitan (8.38) areas showed similar changes and trends were parallel. Highest number of deaths were seen in Decedent’s home (41.75%). Conclusions: Following a period of rise in AAMR, ovarian cancer-related mortality has declined since 2003. The highest AAMRs were observed among White elderly females. Targeted strategies are needed to further prevent mortality from ovarian cancer in high risk groups, especially dealing with the racial disparities. Demographic characteristics of deaths due to ovarian cancer in women of the United States from 1999-2020. Variable Subgroup Deaths AAMR (95% CI) per 1000,000 Overall Overall 338,215 8.32 (8.18-8.45) Urbanization Metro 280,218 8.31 (8.16-8.45) Non-metro 57,997 8.38 (8.06-8.71) Race Hispanic 19,813​ 5.96 (5.54-6.37) Black 29,959 7.08 (6.70-7.47) White 297,918 8.64 (8.49-8.79) Age (years) 25-44 10,660 1.20 (1.09-1.30) 45-64 101,706 11.25 (10.93-11.58) 65+ 225,253 43.09 (42.25-43.93)