Ovarian cancer: Survival and treatment differences by age

Abstract

Background. Cancer of the ovary is a disease of older American women with an incidence rate of 9.4 per 100,000 for those under 65 compared to 54.8 per 100,000 for those 65 years of age and over. Methods. Over 22,000 women were diagnosed with ovarian cancer between 1973 and 1987 within the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute. SEER is a population‐based program that covers nearly 10% of the U.S. population for cancer incidence and survival. Results. Ovarian cancer survival rates vary dramatically by stage. Within stage, however, differences are noted in survival by age, with younger women surviving better than older women even after adjustment for the general life expectancy of each age group (relative survival). For Stages III‐IV disease, women under 45 years of age have a 5‐year relative survival rate of over 45% compared to only 8% for those 85 years of age and over. Between 1973–1977 and 1983–1987, the treatment for Stages III‐IV disease has changed. For all age groups, there were sharp increases in the percentage having surgery and chemotherapy/hormonal therapy and decreases in those having surgery and radiation as part of the first course of therapy. Over 40% of women 85 years of age and over did not receive any definitive treatment according to the hospital medical record. In 1983–1987, younger women received more combination therapy (surgery with chemotherapy/hormonal therapy) versus older women who received more single modalities such as surgery only or chemotherapy/hormonal therapy only. Conclusions. Older women with ovarian cancer are treated less aggressively than their younger counterparts and have poorer survival rates.