Causes of death among women with epithelial ovarian cancer by length of survival post-diagnosis: a population-based study in British Columbia, Canada

Abstract

ObjectivesLittle is known regarding the health of women who survive more than 5 years following their ovarian cancer diagnosis. To bridge an important gap in our knowledge about long term health of ovarian cancer survivors, we examined the causes of death among women diagnosed with epithelial ovarian cancer between 1990 and 2014 in British Columbia. These causes were stratified by years since diagnosis, and compared with age- standardized causes of death among women who have not been diagnosed with ovarian cancer.MethodsWe examined all women with epithelial ovarian cancer in British Columbia 1990–2014 using population- based administrative datasets. We stratified women into three groups: all epithelial ovarian cancer patients; women surviving 5 to 9 years post-diagnosis, and women surviving 10 or more years since diagnosis. All- cause and cause specific standardized mortality ratios (SMRs) were calculated.ResultsThere were 4246 deaths among 6427 women with epithelial ovarian cancer. About 55.9% of deaths were from ovarian cancer. When compared with the general population, the highest SMRs (SMR of 5 or higher) were for deaths from other cancers and external causes (44.4% from falls) among women surviving 5–9 years and 10 or more years post-diagnosis. Mortality from other cancers can largely be explained by deaths from breast cancer (15.8%), lung cancer (12.3%), and colorectal cancer (11%).ConclusionsWhile the majority of epithelial ovarian cancer patients continue to die from their ovarian cancer, our results suggest that long term ovarian cancer survivors are particularly vulnerable to deaths from other cancers and from falls in elderly survivors. These data could indicate closer surveillance for breast, lung, and colorectal cancer, and closer attention to bone health is warranted among women surviving for 5 or more years following their epithelial ovarian cancer diagnosis.

Non‐cancer death causes after ovarian cancer diagnosis: A population‐based cohort

“…20,21 Regarding death due to other (non-ovary) cancers, risk of death decreases with time after OC diagnosis. These findings agree with a previous Canadian study on patients with epithelial OC, 22 where other cancers were the second highest death cause in long-term OC survivors, after OC. This is a vitally relevant finding in the follow-up and counseling of patients, regarding the risk of developing other cancers.…”

GCIG-Consensus guideline for Long-term survivorship in gynecologic Cancer: A position paper from the gynecologic cancer Intergroup (GCIG) symptom benefit committee

“…Mortality due to second primary cancers, cardiovascular disease, and external causes such as falls, increases with time since diagnosis. The authors postulated the importance of prevention/early detection of secondary cancer and fall prevention/prophylaxis of osteoporosis [34]. Secondary cancer was observed in 7.5% in an analysis of more than 4000 ovarian long-term survivors.…”

Disease-Specific Survival of Type I and Type II Epithelial Ovarian Cancers—Stage Challenges Categorical Assignments of Indolence & Aggressiveness

“…There are several compelling reasons to examine DSS. First, although ovarian cancer is the leading cause of death for women diagnosed with EOC [29,30], among 10+ year survivors of EOC half again as many succumbed to other cancers while death due to other causes (cardiovascular disease, chronic conditions, accidents/etc) was responsible for more deaths than EOC (184%) [31]. Thus, it is important to understand the true mortality due to EOC, which is the focus of the present work.…”