Demographic Factors

The incidence of ovarian cancer varies with race as well as country of origin. In the United States, ovarian cancer is more common among white women than among black women. The North American Association of Central Cancer Registries (NAACCR) data file for the period 1992-1997 contains information regarding 59,277 women with invasive ovarian cancer (35). For racial categorization, 53,496 (90.2%) were white, 3589 (6.1%) were black, 81 (0.1%) were American Indian, and 1596 (2.7%) were Asian/Pacific Islander. This analysis confirmed previous reports that white women in the United States are at a substantially higher risk for ovarian cancer compared with women of other racial and ethnic groups, especially, women of Asian/Pacific Islander ancestry. Surveillance, epidemiology, and end results (SEER) data for the period 1988-1992 showed even higher differences. The ovarian cancer rate among white women in the SEER program was 15.8 per 100,000 and that among black women was 10.2 per 100,000 compared with NAACCR rates of 13.1 per 100,000 and 9 per 100,000, respectively, for white and black women (36).

Residents of industrialized nations and affluent areas, such as Western Europe and North America have higher rates of ovarian cancer. The incidence of ovarian malignancies has been reported to be 14.9 per 100,000 for residents of Sweden and 13.3 per 100,000 for residents of the United States compared with only 4.6 per 100,000 for residents of India (37). Some postulated that differences in parity and use of oral contraceptives may in part account for the variation in ovarian cancer incidence between industrialized and nonindustrialized nations (38,39). Although, it is interesting to note that the incidence of ovarian cancer is only 2.7 per 100,000 for residents of Japan (37) and 3.2 per 100,000 for native-born Japanese immigrants in the United States, though the rate for second and third generation Japanese-Americans approximates the rate of other native-born Americans (40). Notably, the incidence of ovarian cancer among women of Jewish descent, whether born in the United States or Europe, is reported to be among the highest in the world, at 14.3 per 100,000 (37).

Racial differences affect survival rates as well. Several studies have documented higher rates of mortality among white women compared with women of other races (41-43). For the period 1973-1977, the National Cancer Institute reported the age-adjusted mortality rate to be 8.7 per 100,000 for white women compared with only 6.9 for black women (44). In a more recent evaluation of data from the NAACR for the period 1992-1997 (45) age-adjusted ovarian cancer mortality rates per 100,000 were reported to be 7.8 for white women, 6.4 for black women, 4.2 for American Indian women, and 4.1 for women of Asian/Pacific island descent.

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