Trends of ovarian cancer incidence by histotype and race/ethnicity in the United States 1992-2019


 The effect of risk factors on ovarian cancer differs by histotype, and the prevalence of such risk factors varies by race/ethnicity. It is not clear how ovarian cancer incidence has changed over time by histotype and race/ethnicity. We used the Surveillance, Epidemiology, and End Results Program (SEER-12) 1992-2019 data to examine the trend of ovarian cancer incidence for three histotypes (high-grade serous N=19,691, endometrioid N=3,212, and clear cell N=3,275) and four racial/ethnic groups (Asian/Pacific Islander, Hispanic, non-Hispanic Black and non-Hispanic White). Joinpoint and age-period-cohort analyses were conducted to analyze ovarian cancer incidence trends. High-grade serous cancer was the most common histotype, but its incidence has significantly decreased over time for all racial/ethnic groups; the decrease was largest for non-Hispanic White women (average annual percent change AAPC during 2010-2019= -6.1, 95% confidence interval (CI) -8.0 to -4.2). Conversely, clear cell cancer was most common in the Asian/Pacific Islanders, and its incidence has increased over time, particularly among Hispanic and Asian/Pacific Islander women (AAPC during 2010-2019=2.8, 95% CI 0.8 to 4.7, and AAPC=1.5, 95% CI 0.7 to 2.2, respectively). Endometrioid cancer incidence has decreased in non-Hispanic White but increased in Hispanic women (AAPC during 2010-2019= -1.3, 95% CI -1.9 to -0.8, and AAPC=3.6, 95% CI 1.0 to 6.3, respectively). The differential incidence trends by histotype and race/ethnicity underscore the need to monitor incidence and risk factor trends across different groups and develop targeted preventive interventions to reduce the burden of ovarian cancer and disparity by race/ethnicity.