Scientist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA.
Earl Stadtman Investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.
CA Cancer J Clin. 2018 Jul;68(4):284-296. doi: 10.3322/caac.21456. Epub 2018 May 29.
In 2018, there will be approximately 22,240 new cases of ovarian cancer diagnosed and 14,070 ovarian cancer deaths in the United States. Herein, the American Cancer Society provides an overview of ovarian cancer occurrence based on incidence data from nationwide population-based cancer registries and mortality data from the National Center for Health Statistics. The status of early detection strategies is also reviewed. In the United States, the overall ovarian cancer incidence rate declined from 1985 (16.6 per 100,000) to 2014 (11.8 per 100,000) by 29% and the mortality rate declined between 1976 (10.0 per 100,000) and 2015 (6.7 per 100,000) by 33%. Ovarian cancer encompasses a heterogenous group of malignancies that vary in etiology, molecular biology, and numerous other characteristics. Ninety percent of ovarian cancers are epithelial, the most common being serous carcinoma, for which incidence is highest in non-Hispanic whites (NHWs) (5.2 per 100,000) and lowest in non-Hispanic blacks (NHBs) and Asians/Pacific Islanders (APIs) (3.4 per 100,000). Notably, however, APIs have the highest incidence of endometrioid and clear cell carcinomas, which occur at younger ages and help explain comparable epithelial cancer incidence for APIs and NHWs younger than 55 years. Most serous carcinomas are diagnosed at stage III (51%) or IV (29%), for which the 5-year cause-specific survival for patients diagnosed during 2007 through 2013 was 42% and 26%, respectively. For all stages of epithelial cancer combined, 5-year survival is highest in APIs (57%) and lowest in NHBs (35%), who have the lowest survival for almost every stage of diagnosis across cancer subtypes. Moreover, survival has plateaued in NHBs for decades despite increasing in NHWs, from 40% for cases diagnosed during 1992 through 1994 to 47% during 2007 through 2013. Progress in reducing ovarian cancer incidence and mortality can be accelerated by reducing racial disparities and furthering knowledge of etiology and tumorigenesis to facilitate strategies for prevention and early detection. CA Cancer J Clin 2018;68:284-296. © 2018 American Cancer Society.
2018 年,美国预计将有 22240 例卵巢癌新发病例和 14070 例卵巢癌死亡病例。在此,美国癌症协会根据全国人口癌症登记处的发病率数据和国家卫生统计中心的死亡率数据,对卵巢癌的发病情况进行了概述。同时还对早期检测策略的现状进行了综述。在美国,卵巢癌的总体发病率从 1985 年(每 10 万人 16.6 例)下降到 2014 年(每 10 万人 11.8 例),下降了 29%,死亡率从 1976 年(每 10 万人 10.0 例)下降到 2015 年(每 10 万人 6.7 例),下降了 33%。卵巢癌包含一组异质性的恶性肿瘤,其病因、分子生物学和许多其他特征各不相同。90%的卵巢癌为上皮性肿瘤,最常见的是浆液性癌,非西班牙裔白人(NHW)的发病率最高(每 10 万人 5.2 例),非西班牙裔黑人(NHB)和亚洲/太平洋岛民(API)的发病率最低(每 10 万人 3.4 例)。然而,值得注意的是,API 患子宫内膜样癌和透明细胞癌的发病率最高,这些癌症在较年轻的人群中发生,这有助于解释 API 和年龄小于 55 岁的 NHW 上皮性癌症发病率相当。大多数浆液性癌在 III 期(51%)或 IV 期(29%)诊断,2007 年至 2013 年期间诊断的患者的 5 年特异性生存率分别为 42%和 26%。上皮性癌各期的 5 年总生存率,API 最高(57%),NHB 最低(35%),API 和 NHB 几乎在所有诊断阶段的生存率都最低。此外,尽管 NHW 的生存率从 1992 年至 1994 年期间的 40%上升到 2007 年至 2013 年期间的 47%,但 NHB 的生存率几十年来一直处于停滞状态。通过减少种族差异,进一步了解病因和肿瘤发生,加快减少卵巢癌发病率和死亡率的进展,可以促进预防和早期发现的策略。CA Cancer J Clin 2018;68:284-296。© 2018 美国癌症协会。