Saturday, January 31, 2009

Staggering statistics (ie. why more money should go to Ovarian Cancer research)

Brought to you by the Ovarian Cancer National Alliance

Each year, approximately 20,000 American women are diagnosed with ovarian cancer and about 15,000 women die of the disease. In 2008, it is estimated that 21,650 women in the United States will be diagnosed with ovarian cancer and 15,520 women will die from the disease.

Malignant ovarian cancer incidence and death counts
Year
Incidence Count
Mortality Count

2005
22,220
15,0321


2004
20,095
14,716

2003
19,871
14,657

2002
19,177
14,682

2001
19,123
14,414

2000
19,896
14,060

1999
19,556
13,627

Prevalence
Approximately 174,236 women living in the United States have or have a history of ovarian cancer.

Lifetime risks
One in 72 women will develop ovarian cancer (lifetime risk).
One in 95 women will die from ovarian cancer.
A woman’s lifetime risk of developing ovarian cancer is 1.39 percent.
A woman’s risk of developing ovarian cancer and dying from it is 1.05 percent.

Survival and stage at diagnosis
The overall five-year relative survival rate for all women with ovarian cancer is 46 percent. This means that compared to women in the general population, five years from the time of diagnosis only 46 percent of women with ovarian cancer are still alive.
However, the survival rate improves greatly to 93 percent if the cancer is diagnosed at an early stage before it has spread. Only 19 percent of ovarian cancer cases are diagnosed at this local stage.
Approximately 75 percent of ovarian cancer cases are diagnosed at an advanced stage after the cancer has spread beyond the ovary.
The five-year survival rate for women with ovarian cancer has not significantly increased in the past 30 years—a mere 8 percent.
Women diagnosed with ovarian cancer from 1975 to 1979 experienced a five-year survival rate of approximately 38 percent. Today this rate is approximately 46 percent.
Ovarian cancer survival rates have not improved as significantly as those of some other cancers that affect primarily women. For example, women diagnosed with breast cancer from 1975 to 1979 experienced a five-year survival rate of 75 percent and today this rate is 89 percent.

Recurrence
The issue of ovarian cancer recurrence is complicated. Research suggests that between 70 percent to 90 percent of all women with ovarian cancer will, at some point, have a recurrence of their disease. The risk of recurrence varies based on multiple factors, including the stage at diagnosis.

Approximately 90 – 95 percent of patients with stage IV ovarian cancer will have a recurrence at some point.
Approximately 80 – 85 percent of patients with stage III ovarian cancer who are suboptimal (a large volume of residual tumor remains after initial surgery) will have a recurrence.
Approximately 70 – 80 percent of patients with optimal stage III ovarian cancer will have a recurrence.
Approximately 30 percent of patients with stage II ovarian cancer will have a recurrence.
Approximately 10 percent of patients with stage I ovarian cancer will have a recurrence.
Improvements in therapy are resulting in later recurrences. However, researchers are now trying to determine whether the treatments are just delaying the recurrence or whether fewer patients overall are having recurrences.

Background:
None of the registries track this information. It has been gleaned from research articles by Deborah Armstrong, MD of our Scientific and Medical Advisory Committee. The overall number is also in the Johns Hopkins Pathology, education piece on “Treatment of Recurrent Disease”
*Note: This was published in 2002 and is the most current information available.

Age at diagnosis and death
From 2001 to 2005, the most recent period for which data is available, the median age at diagnosis for ovarian cancer was 63 years.
Approximately 87 percent of the women who are diagnosed with ovarian cancer are 45 years or older.
Approximately 68 percent of the women who are diagnosed with ovarian cancer are 55 years or older.
Approximately 32 percent of the women who are diagnosed with ovarian cancer are 54 years or younger.
Approximately 13 percent of women who are diagnosed with ovarian cancer are 45 years or younger.
From 2001 to 2005, the most recent period for which data is available, the median age at death for ovarian cancer was 71 years.
Rank in relation to other cancers: incidence (PDF)
Ovarian cancer is the eighth most common cancer among women in the United States.(2004)


Rank in relation to other cancers: mortality
Ovarian cancer is the fifth leading cause of cancer-related death among U.S. women.

Ovarian cancer has remained the fifth leading cause of cancer-related death among U.S. women since 1999.
Mortality rates are slightly less for minority women than for Caucasian women.
Trends in incidence and mortality
Over the past decade there has been a slight decrease – less than 1 percent per year – in ovarian cancer incidence rates, however, during the same time, the actual incidence numbers increased by approximately 3,000 women.
During most of the past decade (1996 to 2005), the ovarian cancer mortality rate has remained stable.
The breast cancer mortality rate has decreased 2.2 percent per year (1990 to 2005) and the cervical cancer mortality rate has decreased 3.4 percent per year in a similar time period (1995 to 2005).

Early Detection
Early detection of ovarian cancer can save lives. There are two main barriers to early diagnosis – the lack of an ovarian cancer screening test and a lack of ovarian cancer awareness.
Lack of Screening Test – It is important to note that the Pap test does not screen for ovarian cancer; it screens for cervical cancer and some infections. There is currently no test that exists for ovarian cancer that can be used on all women to screen for the disease, such as mammograms for breast cancer and the Pap test for cervical cancer. Methods are being researched to monitor women at high risk for the disease but currently no test exists to screen all women in the general public.

Lack of Awareness – Few women know enough about ovarian cancer and increased awareness is needed among medical professionals. Right now the best chance for early detection is to raise awareness about ovarian cancer among women and the health care community.

Current recommendations
Currently no routine screening test exists for ovarian cancer. If a woman is experiencing ovarian cancer symptoms or has a strong family history or genetic predisposition such as a BRCA mutation, doctors may monitor her with one or a combination of tests:

CA-125 blood test – CA-125 is a protein found in greater concentration in cancerous cells. Although a CA-125 blood test can be a useful tool for the diagnosis of ovarian cancer, it is not uncommon for a CA-125 count to be elevated in premenopausal women due to benign conditions unrelated to ovarian cancer. Uterine fibroids, liver disease, inflammation of the fallopian tubes and other types of cancer can elevate a woman's CA-125 level resulting in a false positive test. The CA-125 test is more accurate in postmenopausal women. However, in about 20 percent of cases of advanced stage ovarian cancer, and 50 percent of cases of early stage ovarian cancer, the CA-125 is NOT elevated, even though there is ovarian cancer present. As a result, the CA-125 is generally one of several tools used to diagnose ovarian cancer. One of the most important uses of the CA-125 test is to evaluate the disease’s progress and tumor response in patients undergoing treatment, and to monitor the levels of women in remission for evidence of disease recurrence. An elevated CA-125 can indicate ovarian cancer; however, as noted above, it may sometimes result in false positives.

Transvaginal ultrasound – A transvaginal ultrasound is a test used to examine a woman’s reproductive organs, mainly: the vagina, the uterus, the fallopian tubes, and the bladder. This is done by inserting a probe into the woman’s vagina. The probe sends off sound waves which reflect off of body structures. The waves are then received by a computer that turns them into a picture the doctor can examine.

Pelvic exam – During this exam a doctor places one or two fingers into a woman’s vagina and another over her abdomen to feel the size, shape and position of the ovaries and uterus. Ovarian cancer is usually in an advanced stage if it is found during a pelvic exam.

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