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. 2017 Feb;144(2):405-413.
doi: 10.1016/j.ygyno.2016.10.019. Epub 2016 Dec 6.

The Histology of Ovarian Cancer: Worldwide Distribution and Implications for International Survival Comparisons (CONCORD-2)

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The Histology of Ovarian Cancer: Worldwide Distribution and Implications for International Survival Comparisons (CONCORD-2)

Melissa Matz et al. Gynecol Oncol. .
Free PMC article

Erratum in

Abstract

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.

Keywords: Epidemiology; Histology; Morphology; Ovarain cancer; Worldwide.

Conflict of interest statement

Conflict of interest

The authors declare there are no conflicts of interest.

Figures

Figure 1
Figure 1. Worldwide distribution of ovarian cancera histology (%): 51 countries, 1995-2009
a Malignancies of the ovary (ICD-O-3 C56.9), fallopian tube, uterine ligaments and adnexa, and other and unspecified female genital organs (C57.0-C57.4, C57.7-C57.9), and peritoneum and retroperitoneum (C48.0-C48.2). Endometrioid tumours are classified as type I epithelial (see text).
Figure 2
Figure 2. Histological groups of ovarian cancera: distribution by continent, 2005-09
a Malignancies of the ovary (ICD-O-3 C56.9), fallopian tube, uterine ligaments and adnexa, and other and unspecified female genital organs (C57.0-C57.4, C57.7-C57.9), and peritoneum and retroperitoneum (C48.0-C48.2). Endometrioid tumours are classified as type I epithelial (see text).
Figure 3
Figure 3. Histological groups of ovarian cancera by country (Asia), 2005-09
a Malignancies of the ovary (ICD-O-3 C56.9), fallopian tube, uterine ligaments and adnexa, and other and unspecified female genital organs (C57.0-C57.4, C57.7-C57.9), and peritoneum and retroperitoneum (C48.0-C48.2). Endometrioid tumours are classified as type I epithelial (see text). *Data with 100% coverage of the national population.

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