Abstract
Because the International Cancer Benchmarking Partnership, in a study of diagnosis years between 1995 and 2007, showed lower-than-expected survival for Manitoba's ovarian cancer patients, we undertook an analysis to describe the features of ovarian cancer diagnosed in Manitoba during a 20-year period. We also determined the most recent trends in survival to see if the previous results were sustained. In this retrospective cohort study, ovarian cancer cases diagnosed during 1992-2011 were extracted from the Manitoba Cancer Registry. The incidence of ovarian cancer was calculated for the overall group and for age, morphology, residence, treatment, and stage. Trends over time, with a particular focus on changes that might correlate with poor survival, were analyzed. The 1- and 3-year relative survival rates were also calculated. The incidence of ovarian cancer did not vary over time (p = 0.640), even when stratified by age or morphology groups. Use of adjuvant chemotherapy decreased (p = 0.005) and use of neoadjuvant chemotherapy increased over time (p = 0.002). Diagnoses of stage iv cancers declined over time (p < 0.020). Trends in incidence did not coincide with previously observed decreases in relative survival. A decline in diagnoses of stage iv ovarian cancer could be responsible for a recent increase in relative survival. However, sample size might have limited power in some analyses, and the previously reported decrease in relative survival might have been due to a random fluctuation in the data. Future efforts will focus on continued monitoring of the patterns of ovarian cancer presentation and outcomes in Manitoba.
Highlights
Because the International Cancer Benchmarking Partnership, in a study of diagnosis years between1995 and 2007, showed lower-than-expected survival for Manitoba’s ovarian cancer patients, we undertook an analysis to describe the features of ovarian cancer diagnosed in Manitoba during a 20-year period
A decline in diagnoses of stage iv ovarian cancer could be responsible for a recent increase in relative survival
That was the period reflected in the icbp publication, but we found that, immediately afterward, Manitoba’s relative survival rate for ovarian cancer was substantially higher
Summary
Because the International Cancer Benchmarking Partnership, in a study of diagnosis years between1995 and 2007, showed lower-than-expected survival for Manitoba’s ovarian cancer patients, we undertook an analysis to describe the features of ovarian cancer diagnosed in Manitoba during a 20-year period. As a result of consistent observations of inferior cancer survival in the United Kingdom, a national cancer plan was developed to improve the cancer patient’s experience within the health care system, including ways of ensuring that cancer patients are seen in a timely manner[4]. In Canada, survival has become a standard outcome measure in the system performance reports published since 20115–8 by the Canadian Partnership Against Cancer, which compare provinces on various statistical measures spanning the cancer control continuum. Canadian provinces have long participated in international efforts to benchmark the success of their cancer control efforts[1,2]. The International Cancer Benchmarking Partnership (icbp) compared cancer survival in a subset of relatively wealthy jurisdictions from the United Kingdom, northern Europe, Australia, and Canada that have similar (public) health care systems, based on cancer cases diagnosed during 1995–20079. Patients diagnosed during 2005–2007 had a 5-year relative survival rate of only 28.8%, which was e78
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