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.
背景：卵巢癌仍是美国致死率最高的妇科恶性肿瘤。本研究旨在分析绝经前与绝经后女性卵巢癌发病率的演变趋势，为未来制定精准干预策略提供依据。方法：这项基于人群的横断面研究分析了2001-2021年美国癌症统计数据库的全人群数据。采用连接点回归模型计算年均百分比变化及其95%置信区间，并按每百万人群计算年龄标准化发病率。结果：2001-2021年间卵巢癌总体发病率呈下降趋势。绝经后女性发病率降幅显著大于绝经前女性。按种族分层分析显示，20-49岁非西班牙裔美洲印第安人/阿拉斯加原住民女性的卵巢癌发病率呈上升趋势，年均变化率为2.4%，而其他种族群体均呈现下降趋势。连接点趋势分析发现三个年龄组局部期卵巢癌发病率均存在一个转折点：20-49岁和65岁以上女性在2001-2011年、50-64岁女性在2001-2012年呈下降趋势，此后至2021年转为上升趋势。同样，20-49岁女性透明细胞型和子宫内膜样卵巢癌发病率也存在类似转折点。结论：美国绝经后女性卵巢癌发病率显著下降，而绝经前女性仅轻微下降。尽管趋势向好，仍需持续完善早期检测与预防策略，以减轻这一致命疾病的负担。
肿瘤(癌症)患者之家