# Trends in the Incidence of Ovarian Cancer Among Premenopausal and Postmenopausal Women in the United States, 2001 to 2021

## TL;DR

Ovarian cancer rates have significantly dropped in postmenopausal women in the US, but only slightly in premenopausal women, highlighting the need for better early detection and prevention.

## Contribution

This study provides a nationwide analysis of ovarian cancer incidence trends in premenopausal and postmenopausal women in the US from 2001 to 2021.

## Key findings

- Ovarian cancer incidence rates declined significantly among postmenopausal women from 2001 to 2021.
- Premenopausal women showed only a slight decline in ovarian cancer incidence rates during the same period.
- Non-Hispanic American Indian/Alaska Native women aged 20–49 experienced an increase in ovarian cancer incidence rates.

## Abstract

In the United States (US), ovarian cancer is the most fatal of all the gynecological cancers. We conducted a nationwide analysis of data spanning the period from 2001 to 2021 to examine trends in ovarian cancer incidence among premenopausal and postmenopausal women, with the aim of informing future targeted interventions. Our findings showed a significant decline in the incidence rate (IR) of ovarian cancer among postmenopausal women, while the decline among premenopausal women was only slight. These results highlight the need for continued concerted efforts to improve early detection and prevention strategies to reduce the burden of ovarian cancer in the US.

Background: Ovarian cancer remains the deadliest and leading cause of gynecological cancer-associated mortality in the US. The aim of this study was to characterize the trends in the incidence of ovarian cancer between premenopausal and postmenopausal women to inform future targeted interventions. Methods: This population-based cross-sectional study analyzed data from the US Cancer Statistics (USCS) database, which covered the whole of the US population between 2001 and 2021. Joinpoint regression was used to compute the average annual percentage change (APC) with 95% confidence interval (CI) and age-standardized incidence rates per 1,000,000 population. Results: The results showed that the IR of ovarian cancer declined between 2001 and 2021. Postmenopausal women had greater decreases in the IR of ovarian cancer compared to premenopausal women who showed a small decline. When stratified by race/ethnicity, non-Hispanic American Indian/Alaska Native women aged 20–49 years experienced an increase in the IR of ovarian cancer (APC = 2.4; 95% CI 0.9 to 4.1) compared to other racial/ethnic groups which showed a decline. Joinpoint trend analyses identified one inflection point in localized ovarian cancer incidence trends among all three age groups: an initial decline from 2001 to 2011 among women 20–49 years old and 65+ years old, and from 2001 to 2012 among women 50–64 years old, followed by an upward trend thereafter to 2021. Similarly, there was one inflection point in the IR of ovarian cancer for the clear cell and endometrioid types among women aged 20–49 years old. Conclusions: The IR of ovarian cancer in the US declined significantly among postmenopausal compared to premenopausal women, for whom the IR of ovarian cancer decreased only slightly. Although encouraging, these findings show a need for continued efforts to improve early detection and prevention strategies to mitigate the burden of this deadly disease.