Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
Royal Marsden Hospital, London, United Kingdom.
Int J Cancer. 2020 Feb 1;146(3):749-758. doi: 10.1002/ijc.32322. Epub 2019 Apr 30.
Ovarian cancer is the eighth most common cancer in women worldwide and incidence rates vary markedly by world region. Our study provides a comprehensive overview of ovarian cancer incidence trends globally, examining the influence of birth cohort and period of diagnosis on changing risk. We presented current patterns and trends of ovarian cancer incidence until 2012 using data from successive volumes of Cancer Incidence in Five Contents. The incidence of ovarian cancer is highest in northern and eastern European countries and in northern America. Declining trends were observed in most countries with the exception of a few central and eastern Asian countries. Marked declines were seen in Europe and North America for women aged 50-74 where rates have declined up to 2.4% (95% CI: -3.9, -0.9) annually in Denmark (DNK) over the last decade. Additionally, declines in the incidence rate ratio (IRR) were observed for generations born after the 1930s, with an additional strong period effect seen around 2000 in United States and DNK. In contrast, IRRs increased among younger generations born after the 1950s in Japan and Belarus. Overall, the favorable trends in ovarian cancer incidence is likely due to the increase use of oral contraceptive pills, and changes in the prevalence of other reproductive risk and protective factors for ovarian cancer over the years studied. Changes in disease classifications and cancer registry practices may also partially contribute to the variation in ovarian cancer incidence rates. Thus, continuous cancer surveillance is essential to detect the shifting patterns of ovarian cancer.
卵巢癌是全世界第八大常见女性癌症，其发病率在世界各地区差异显著。我们的研究提供了全球卵巢癌发病率趋势的综合概述，研究了出生队列和诊断时期对风险变化的影响。我们使用来自《五大洲癌症发病率》连续卷的数据，展示了截至 2012 年卵巢癌发病率的当前模式和趋势。卵巢癌发病率在北欧和东欧国家以及北美最高。除了少数中亚和东亚国家外，大多数国家的发病率呈下降趋势。在欧洲和北美，50-74 岁年龄段的妇女的发病率显著下降，丹麦在过去十年中，该年龄段的发病率每年下降 2.4%（95%CI：-3.9，-0.9）。此外，在 2000 年前后，美国和丹麦还观察到出生于 20 世纪 30 年代以后的几代人的发病率比（IRR）下降，且存在强烈的时期效应。相比之下，在日本和白俄罗斯，出生于 20 世纪 50 年代以后的年轻几代人的 IRR 有所增加。总体而言，卵巢癌发病率的有利趋势可能归因于口服避孕药的广泛使用，以及多年来其他生殖风险和保护因素对卵巢癌的流行情况的改变。疾病分类和癌症登记处做法的变化也可能部分导致卵巢癌发病率的差异。因此，持续的癌症监测对于发现卵巢癌模式的变化至关重要。
