44 - Ovary

Summary

Introduction

Although ovarian cancer is only moderately frequent, it is the most common cause of death from gynecological neoplasms in western countries. The range of geographical variation is modest.

Histology, classification and diagnosis

The majority of tumors are serous or pseudomucinous cystadenocarcinomas which arise from celomic epithelium. Malignant germ cell tumors, such as granulosa-cell carcinoma, are comparatively rare, and occur at younger ages. As many cancers remain clinically silent for a considerable period, prognosis tends to be poor.

Descriptive epidemiology

Incidence Highest rates are observed in Hawaiian and Pacific Island Polynesians (25.8). In contrast, rates in New Zealand Maoris (10.9) are much lower, the incidence being the same as in non-Maoris. The highest rates reported from Europe are 17.3 in the Ardeche in France and just over 15 for Norway, Sweden and migrants to Israel born in Europe or North America. Most rates in Europe and North America range between 8 and 12. Rates for US blacks are about two-thirds of those for whites (Fig. 44.1). While women in Asia have a relatively low incidence, in the 5 to 7 range, Chinese and Japanese who reside in the USA tend to show slightly higher rates.

In most registries, few changes over time have been observed but slight rises have been reported in both Japanese and Singapore Chinese.