The incidence and mortality of ovarian cancer and their relationship with the Human Development Index in Asia

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 Table 1. Number, crude and standardised incidence rates, and mortality from ovarian cancer in Asian countries in 2012 (sorted by age-standardised rate from the highest to lowest).

Limitations

This was an ecological study. Result of this type of study should be interpreted at the population level, and ecological fallacy will occur if results are inferred and concluded at the individual level. Some other factors such as the number of reproductive and contraceptive factors that suppress ovulation, including gravidity, breast feeding, and oral contraception, reduce the risk of ovarian cancer, and gynaecologic surgeries including hysterectomy and tubal ligation were protective. Some of the environmental factors and medical conditions that increased risk of disease included talc use, endometriosis, ovarian cysts, and hyperthyroidism. However, in this study we do not have access to enough information on these factors to consider their role in the incidence and mortality of ovarian cancer in Asian countries. Therefore, it is suggested that in addition to ecological studies, in each of these countries, studies in the form of case-control or cohort studies should be done to determine the role of factors related to the incidence and mortality from this disease on an individual level.