Long-term mortality among women with epithelial ovarian cancer

Abstract

Objectives Patients with solid tumors are at greatest risk for dying from their cancers in the five years following diagnosis. For most malignancies, deaths from other chronic diseases begin to exceed those from cancer at some point. As little is known about the causes of death among long-term survivors of ovarian cancer, we examined causes of death by years from diagnosis. Methods The Surveillance, Epidemiology, and End Results (SEER) database was used to identify women diagnosed with ovarian cancer between 1988 and 2012. We compared causes of death by stage, age, and interval time after diagnosis. Results A total of 67,385 women were identified. For stage I neoplasms, 13.6% (CI, 13.0-14.2%) died from ovarian cancer, 4.2% (CI, 3.8-4.5%) from cardiovascular disease, 3.6% (CI, 3.3-3.9%) from other causes and 2.6% (CI, 2.4-2.9%) from other tumors; ovarian cancer was the leading cause of death until 7 years after diagnosis after which time deaths are more frequently due to other causes. For those with stage III-IV tumors, 67.8% (CI, 67.3-68.2%) died from ovarian cancer, 2.8% (CI, 2.6-2.9%) from other causes, 2.3% (CI, 2.2-2.4%) from cardiovascular disease and 1.9% (CI, 1.7-2.0%) from other cancers; ovarian cancer was the most frequent cause of death in years 1-15 after which time deaths were more commonly due to other causes. Conclusions The probability of dying from ovarian cancer decreases with time. Ovarian cancer remains the most common cause of death for 15 years after diagnosis in women with stage III-IV tumors.

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

“…Our results are consistent with those previously reported using Surveillance Epidemiology and End Results (SEER) data 3. We observed that the proportion of deaths from ovarian cancer decreased dramatically with increasing years since diagnosis.…”

“…There may also be misclassification if the physician signing the cause of death is not aware of ovarian cancer, and thus assigns a secondary cause (eg, bowel obstruction) as the primary cause of death despite the fact that the obstruction resulted from the cancer. However, given the consistency in the proportion of women with ovarian cancer as their primary cause of death with prior research,3 we expect this misclassification was minimal. Second, while we chose to report major groups of causes of deaths, we ended up with nearly 100 deaths that were from unclassified causes.…”

“…It is the fifth most common cause of cancer related deaths among Canadian women 2. While 5 year survival rates are better when ovarian cancer is detected in stages I and II, the majority of women are diagnosed in advanced stages (stages III and IV) due to its asymptotic presentation in the early stages 3. There is also no effective screening method for ovarian cancer.…”

“…However, as the length of time from diagnosis increases, the risk of death from cancer significantly decreases, and patients begin to die from other causes 3. Largely because 5- year ovarian cancer survival rates have remained relatively low, little attention has been paid to long term ovarian cancer survivors.…”

Review: Mechanotransduction in ovarian cancer: Shearing into the unknown

“…While significant advancements in treatment therapies and success rates have been observed in some cancers, there has been no significant progress in ovarian cancer treatment over the past 50 years. 3,4 Much of this failure arises from the lack of early detection capabilities, with 60%-70% of all patients diagnosed at advanced stages (III or IV), 1,[5][6][7][8] and an 85% recurrence rate. 9 Ovarian cancer is categorized by the cell of origin, with approximately 90% originating from epithelial cells.…”