UBC Theses and Dissertations
Incidence, survival and mortality among women with epithelial ovarian cancer by histotype : a population study in British Columbia, Canada Arora, Nimisha
Objectives. Epithelial Ovarian cancer (EOC) is composed of five distinct histologic subtypes. However, histotype- specific survival and mortality estimates among women with EOC are limited. Also, we lack information on long-term health conditions faced by ovarian cancer survivors. This thesis examined: 1) histotype- specific incidence and survival rates among women with EOC in British Columbia (BC); 2) causes of death among women with EOC by histotype; and, 3) compared these causes of death to age-standardized causes of death in the general population. Methods. Using population-based administrative datasets, I built two population-based cohorts of all women with EOC diagnosed in BC: 1. women diagnosed between 1980 and 2015(cohort 1) and women diagnosed between 1990 and 2014 (cohort 2). Cohort 1 was used to answer question 1, whereas cohort 2 was used to answer question 2 and 3. For question 2, I compared the causes of death within histotypes, by age at diagnosis, BRCA status, and time since diagnosis. For question 3, I calculated all-cause and cause-specific standardized mortality ratios. Results. Decreasing incidence rates and increasing survival rates were observed among women with EOC in BC. As expected, ovarian cancer was the most common cause of death among these women, which was first surpassed by other causes of deaths at 11 years after diagnosis. When stratified by serous and non- serous EOCs, ovarian cancer was the leading cause of death for 12 years and for 8 years respectively after diagnosis. Of particular interest, the number of deaths from other cancers (breast, colorectal and lung cancer) and external causes (falls) among long-term ovarian cancer survivors (5-9 and 10+ years post diagnosis) were higher than the expected. Conclusions. Although there was an improvement in the survival over time, ovarian cancer remains the leading cause of death for 11 years following diagnosis of EOC. My findings suggest that long-term survivors (those living 5-9 and 10+ years following diagnosis) are particularly vulnerable to deaths from other cancers and from falls in elderly survivors. Hence, these women may benefit from closer surveillance of other cancers and bone health.
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