Abstract
Current reported incidence rates for ovarian cancer may significantly underestimate the true rate because of the inclusion of women in the calculations who are not at risk for ovarian cancer due to prior benign salpingo-oophorectomy (SO). We have considered prior SO to more realistically estimate risk for ovarian cancer. Kentucky Health Claims Data, International Classification of Disease 9 (ICD-9) codes, Current Procedure Terminology (CPT) codes, and Kentucky Behavioral Risk Factor Surveillance System (BRFSS) Data were used to identify women who have undergone SO in Kentucky, and these women were removed from the at-risk pool in order to re-assess incidence rates to more accurately represent ovarian cancer risk. The protective effect of SO on the population was determined on an annual basis for ages 5–80+ using data from the years 2009–2013. The corrected age-adjusted rates of ovarian cancer that considered SO ranged from 33% to 67% higher than age-adjusted rates from the standard population. Correction of incidence rates for ovarian cancer by accounting for women with prior SO gives a better understanding of risk for this disease faced by women. The rates of ovarian cancer were substantially higher when SO was taken into consideration than estimates from the standard population.
Highlights
Cancer incidence rates are calculated by dividing new primary cancer cases of a disease by the population at risk in the same time period adjusted by the US standard population [1]
To calculate the cancer incidence rates, the most recent five-year ovary cancer cases diagnosed in years 2009–2013 from the Kentucky Cancer Registry (KCR) were extracted
The corrected age-adjusted rate from the Behavioral Risk Factor Surveillance System (BRFSS) prevalence estimates of SO was 17.7, which is higher than the highest estimates from the Kentucky Health Claims Data (KHCD) data (16.9 per 100,000)
Summary
Cancer incidence rates are calculated by dividing new primary cancer cases of a disease by the population at risk in the same time period adjusted by the US standard population [1]. This assessment has great importance clinically, especially for gynecologic oncology with regard to training a sufficient number of physician specialists. There is an inherent problem in the incidence calculation for some malignancies due to the inclusion of patients in the denominator who are not at risk for the disease [2] In gynecologic oncology, this has been most thoroughly evaluated in the case of endometrial cancer and hysterectomy.
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