A Snapshot of Ovarian Cancer
Incidence and Mortality
Ovarian cancer accounts for approximately 3 percent of all cancers in women and is the fifth leading cause of cancer-related death among women in the United States. In 2014, it is estimated that nearly 22,000 women will be diagnosed with ovarian cancer in the United States, and approximately 14,000 will die of the disease. Ovarian cancer incidence rates declined by nearly 1 percent annually from 1987 to 2011; mortality rates fell an average of 1.6 percent each year from 2001 to 2010. White women have higher incidence and mortality rates than women of other racial/ethnic groups.
Ovarian cancer causes more deaths than any other female reproductive system cancer. This high mortality rate reflects, in part, a lack of early symptoms and a lack of effective screening tests. Thus, ovarian cancer often is diagnosed at an advanced stage, after the disease has spread beyond the ovary.
Risk factors for ovarian cancer include a family history of ovarian cancer; the presence of certain genetic mutations, such as mutations in BRCA1 and BRCA2 and genes linked to hereditary nonpolyposis colorectal cancer (also known as Lynch syndrome); use of estrogen-only hormone replacement therapy; use of fertility drugs; use of talc; obesity; and tall height. Women who are known to have an increased risk of ovarian cancer due to genetic mutations but no signs of the disease may consider risk-reducing surgery to remove the ovaries and fallopian tubes. Standard treatments for ovarian cancer include surgery, radiation therapy, and chemotherapy.
Assuming that incidence and survival rates follow recent trends, it is estimated that $4.7 billion1 will be spent on ovarian cancer care in the United States in 2014.
Examples of NCI Activities Relevant to Ovarian Cancer
- Researchers with The Cancer Genome Atlas (TCGA) program are systematically identifying the major genomic changes involved in more than 20 cancers, including ovarian cancer, using state-of-the-art genomic technologies. In addition, the TCGA Pan-Cancer analysis project is comparing mutations across tumor types to identify genomic similarities; such similarities could raise the prospect that similar treatments could be useful for multiple cancer types. [PubMed Abstract]
- NCI is supporting an extended follow-up of the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial, a large randomized clinical trial that was designed to determine the effects of screening on cancer-related mortality. Through the ongoing Etiology and Early Marker Studies, a component of the PLCO trial, researchers are analyzing biological materials and risk factor information that were collected from PLCO trial participants before the diagnosis of disease to better understand ovarian cancer risk factors and to identify early biomarkers of disease.
- The Early Detection Research Network (EDRN) is identifying and testing new biomarkers to enhance cancer detection and risk assessment. In an ongoing project, the EDRN Breast and Gynecologic Cancers Research Group is validating candidate protein markers for the early detection of ovarian cancer.
- The Clinical Proteomic Tumor Analysis Consortium is characterizing the entire set of proteins expressed by various cancer types, including ovarian tumors, and integrating this information with genomic data from The Cancer Genome Atlas program. The results of this research will provide a better understanding of cancer biology and facilitate the discovery of protein targets with diagnostic and therapeutic utility.
- The phase I trial AZD2281 Plus Carboplatin to Treat Breast and Ovarian Cancer is studying the use of the experimental drug AZD2281 (a type of drug known as a PARP inhibitor) in combination with standard chemotherapy to determine optimum drug doses, evaluate tumor response to the drug combination, and determine the side effects.
- Five ovarian-cancer-specific Specialized Programs of Research Excellence (SPOREs) are conducting ovarian cancer research in early detection, imaging technologies, risk assessment, immunosuppression and novel therapeutic approaches.
Selected Advances in Ovarian Cancer Research
- In a study of postmenopausal women who were at moderate risk of ovarian cancer, high positive predictive value was obtained using a two-stage screening strategy. The first stage involved the use of the Risk of Ovarian Cancer Algorithm (ROCA), a mathematical model that calculates the risk of ovarian cancer based on a woman’s age and changes in her level of the CA-125 antigen over time. The second stage involved follow-up with women classified by ROCA as being at high risk of ovarian cancer.
- Among women evaluated for infertility, there was no association of ovarian cancer risk with having ever used the ovulation-inducing drugs clomiphene citrate (CC) or gonadotropins, except in women who had used CC and never became pregnant. Published September 2013. [PubMed Abstract]
- In a genomic analysis of tumors from 429 women with ovarian cancer, most of whom had no family history of the disease, 20 percent of the tumors had inherited mutations in genes that have been linked to inherited breast and ovarian cancers, and 37 percent had either inherited or acquired mutations in the Fanconi anemia pathway. Published January 2014. [PubMed Abstract]
- An analysis of pooled data from 12 case-control studies found that women who took aspirin regularly had a 20-34 percent lower risk of ovarian cancer than those who did not, with the greatest risk reduction in women who took aspirin daily and who took low-dose aspirin. Published February 2014. [PubMed Abstract]
Trends in NCI Funding for Ovarian Cancer Research
NCI’s investment2 in ovarian cancer research was $100.6 million in fiscal year (FY) 2013. In addition to the funding described in the graph, NCI supported $22 million in ovarian cancer research in FYs 2009 and 2010 using funding from the American Recovery and Reinvestment Act.
Additional Resources for Ovarian Cancer
- NCI Ovarian Cancer Home Page
Information about ovarian cancer treatment, prevention, genetics, causes, screening, clinical trials, research and statistics from the National Cancer Institute.
- BRCA1 and BRCA2: Cancer Risk and Genetic Testing
A fact sheet about the BRCA1 and BRCA2 genes, what to do if a person tests positive for one of these alterations, and the consequences of genetic testing.
- Ovarian Epithelial Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of ovarian epithelial cancer.
- Ovarian Germ Cell Tumors Treatment (PDQ®)
Expert-reviewed information summary about the treatment of ovarian germ cell tumors.
- Ovarian Low Malignant Potential Tumors Treatment (PDQ®)
Expert-reviewed information summary about the treatment of ovarian low malignant potential tumors.
- Clinical Trials for Ovarian Epithelial Cancer
- Clinical Trials for Ovarian Germ Cell Tumors
- Clinical Trials for Ovarian Low Malignant Potential Tumors
- 1 Cancer Prevalence and Cost of Care Projections, in 2010 dollars.
- 2 The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.