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abstract
The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2)the CONCORD Working Group
Highlights
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- The distribution of ovarian tumour subtypes varies by continent and country.
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- Asia has a higher proportion of tumours with better survival.
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- There is wide variation in the distribution within continents.
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- The proportions of type I and type II tumours should be considered in analysis.
Objective
Ovarian
cancers comprise several histologically distinct tumour groups with
widely different prognosis. We aimed to describe the worldwide
distribution of ovarian cancer histology and to understand what role
this may play in international variation in survival.
Methods
The
CONCORD programme is the largest population-based study of global
trends in cancer survival. Data on 681,759 women diagnosed during
1995–2009 with cancer of the ovary, fallopian tube, peritoneum and
retroperitonum in 51 countries were included. We categorised ovarian
tumours into six histological groups, and explored the worldwide
distribution of histology.
Results
During
2005–2009, type II epithelial tumours were the most common. The
proportion was much higher in Oceania (73.1%), North America (73.0%) and
Europe (72.6%) than in Central and South America (65.7%) and Asia
(56.1%). By contrast, type I epithelial tumours were more common in Asia
(32.5%), compared with only 19.4% in North America. From 1995 to 2009,
the proportion of type II epithelial tumours increased from 68.6% to
71.1%, while the proportion of type I epithelial tumours fell from 23.8%
to 21.2%. The proportions of germ cell tumours, sex cord-stromal
tumours, other specific non-epithelial tumours and tumours of
non-specific morphology all remained stable over time.
Conclusions
The
distribution of ovarian cancer histology varies widely worldwide. Type I
epithelial, germ cell and sex cord-stromal tumours are generally
associated with higher survival than type II tumours, so the proportion
of these tumours may influence survival estimates for all ovarian
cancers combined. The distribution of histological groups should be
considered when comparing survival between countries and regions.
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