Ovarian Cancer Awareness Month Draws Attention to Uneven Declines in Mortality

This Ovarian Cancer Awareness Month, recent research shows that despite overall declines in ovarian cancer mortality, significant disparities persist across racial, ethnic, age, and geographic groups, underscoring the need for targeted interventions.

Ovarian Cancer Awareness Month Established to Encourage Vigilance, Early Action

September first became a time for national ovarian cancer awareness when President Bill Clinton recognized September 13 to 19, 1998, as Ovarian Cancer Awareness Week.¹ The National Ovarian Cancer Coalition expanded the observance to the entire month in 2000, and in 2001, President George W. Bush formally designated September as Ovarian Cancer Awareness Month. It has been recognized annually ever since.

In his proclamation, Bush noted that experts expected more than 23,000 ovarian cancer cases to be diagnosed in 2001 and approximately 13,900 women to die of the disease.² He emphasized that ovarian cancer is “very treatable when detected early,” yet only 25% of US patients are diagnosed at an early stage. Because of this, Bush highlighted the importance of early detection and encouraged women to educate themselves on ovarian cancer symptoms and risk factors.

Ovarian cancer deaths remain uneven across age, geography, and racial and ethnic groups, highlighting the need for targeted interventions. | Image Credit: Rana - stock.adobe.com

Declines in Mortality Mask Persistent Gaps Across Age, Region, and Race

Since the launch of Ovarian Cancer Awareness Month, US ovarian cancer mortality rates have declined, yet disparities remain across age groups, geographic regions, and certain racial and ethnic populations.³

To better understand these trends, the authors of a recent study published in World Journal of Clinical Oncology conducted a retrospective analysis of US women aged 25 and older using de-identified death certificate data from the CDC Wide-Ranging Online Data for Epidemiologic Research database. Their analysis examined demographic and regional differences in ovarian cancer-related deaths from 1999 to 2020 to identify high-risk populations and shifts in epidemiology over time.

Between 1999 and 2020, 337,619 women aged 25 or older died from ovarian cancer in the US. At the beginning of the study period, the overall age-adjusted mortality rate (AAMR) was 14.62 per 100,000 people and remained relatively stable until 2003, when it reached 14.7 per 100,000 (annual percent change [APC], 0.41; 95% CI, –0.48 to 1.79). The AAMR significantly declined after 2003, falling to 10.15 per 100,000 by 2020 (APC, –2.28; 95% CI, –2.39 to –2.16).

In terms of age-specific trends, women aged 65 and older consistently had the highest AAMRs, with a total rate of 42.41 per 100,000 (95% CI, 42.23-42.59). In comparison, women aged 45 to 64 years had a total AAMR of 11.09 per 100,000 (95% CI, 11.02-11.16), while those aged 25 to 44 had the lowest rate at 1.16 per 100,000 (95% CI, 1.14-1.19).

By geographic region, the Northeast had the highest total AAMR at 13.06 per 100,000 (95% CI, 12.96-13.16), followed by the Midwest (12.94; 95% CI, 12.85-13.03), the West (12.86; 95% CI, 12.76-12.95), and the South (12.16; 95% CI, 12.09-12.23). Specifically, nonmetropolitan regions had a slightly higher total AAMR (12.84; 95% CI, 12.74-12.95) than metropolitan areas (12.61; 95% CI, 12.58-12.66).

As for race and ethnicity, non-Hispanic White women had the highest total AAMR at 13.53 per 100,000 (95% CI, 13.48-13.58), followed by non-Hispanic Black women (11.02; 95% CI, 10.89-11.15), non-Hispanic American or Alaska Native women (9.85; 95% CI, 9.34-10.36), Hispanic or Latina women (8.94; 95% CI, 8.81-9.07), and non-Hispanic Asian or Pacific Islander women (7.56; 95% CI, 7.4-7.73).

“If I were to sum it up, I would say that non-Hispanic White women, older women aged greater than 65 years, the Northeastern and Midwestern regions, states like Oregon, and rural areas are the key areas that we should focus on and that have the highest AAMR when it comes to ovarian cancer,” Muhammad Faizan, MBBS, an emergency medicine resident at Hamad Medical Corporation and one of the study’s authors, said in an interview with The American Journal of Managed Care^® (AJMC^®).⁴

Disaggregated Data Highlight Survival Differences Among Asian American, Native Hawaiian, and Pacific Islander Women

Although non-Hispanic Asian or Pacific Islander populations had the lowest AAMR in this study, the authors of an abstract presented at the 2025 American Society of Clinical Oncology Annual Meeting emphasized that grouping these populations together may mask differences in socioeconomic status and health behaviors.⁵

“…when we start analyzing Asian Americans as a single group, these ethnic-specific differences just get overlooked,” Alice W. Lee, PhD, MPH, an investigator of a related study, said in an interview with AJMC.⁶ “In turn, any differences across ethnicities that we're seeing when it comes to cancer risk and cancer survival also end up becoming completely masked. What ends up happening is that what we see in what we call the aggregate ends up being associated with every single Asian ethnic subgroup.”

To reveal these differences, the researchers compared disaggregated ovarian cancer survival outcomes among Asian American, Native Hawaiian, and Pacific Islander women with those of a non-Hispanic White women reference group.⁵ The Asian American, Native Hawaiian, and Pacific Islander cohort was further divided into subgroups: East Asian, South Asian, Southeast Asian, and Native Hawaiian and other Pacific Islander.

Using data from the National Cancer Database, the researchers identified patients diagnosed with epithelial ovarian cancer between 2004 and 2022. The study included 212,441 non-Hispanic White patients and 7803 Asian American, Native Hawaiian, and Pacific Islander patients. Of these, 2909 were East Asian, 2455 were Southeast Asian, 1901 were South Asian, and 538 were Native Hawaiian and other Pacific Islanders.

Although Asian American, Native Hawaiian, and Pacific Islander patients had significantly longer survival times than non-Hispanic White patients when evaluated as a single group (128.46 months vs 95.17 months; P < .001), disaggregated data revealed survival disparities across subgroups.

The researchers found that East Asian patients experienced better survival (128.94 months) than both Southeast Asian (121.67 months; P < .032) and Native Hawaiian and other Pacific Islander (114.77 months; P < .047) patients. Consequently, Southeast Asian (HR, 1.137; 95% CI, 1.036-1.248) and Native Hawaiian and other Pacific Islander (HR, 1.334; 95% CI, 1.135-1.568) patients had significantly higher risks of death than East Asian patients.

These results suggest that although Asian American, Native Hawaiian, and Pacific Islander populations with ovarian cancer may have better overall survival than non-Hispanic White patients, significant disparities emerge when these groups are examined separately.

“This understanding will lend to greater overall equity as we aim to target disparities across ethnic cohorts,” the researchers concluded.

Targeted Interventions Proposed to Reduce Ovarian Cancer Disparities

Given the persistence of ovarian cancer mortality disparities, researchers urged the need for targeted interventions.⁷ Abdul Rafae Faisal, MBBS, CMH Multan Institute of Medical Sciences, suggested to AJMC that clinicians expand genetic counseling, targeting families with a history of BRCA1 mutations, as well as racial groups more vulnerable to them, as they are at higher risk of developing ovarian cancer.

He also called for improvements to insurance coverage for at-risk demographics and racial groups to encourage early detection. Lastly, Faisal emphasized the need to move away from one-size-fits-all treatment approaches.

“These are a few things I’m sure would help reduce the burden of a problem that we’ve already tackled quite well and would go a long way towards improving outcomes further,” he concluded.

References

1. McCormick B. Ovarian Cancer Awareness Month: prioritizing early detection, bridging equity gaps. AJMC. September 30, 2024. Accessed September 2, 2025. https://www.ajmc.com/view/ovarian-cancer-awareness-month-prioritizing-early-detection-bridging-equity-gaps
2. National Ovarian Cancer Awareness Month, 2001. Federal Register. August 30, 2001. Accessed September 2, 2025. https://www.federalregister.gov/documents/2001/09/05/01-22474/national-ovarian-cancer-awareness-month-2001
3. McCormick B. Disparities persist despite declining US ovarian cancer death rates. AJMC. July 9, 2025. Accessed September 2, 2025. https://www.ajmc.com/view/disparities-persist-despite-declining-us-ovarian-cancer-death-rates
4. McCormick B. Older, White and rural women remain at risk despite decline in US ovarian cancer mortality: Muhammad Faizan, MBBS. AJMC. July 29, 2025. Accessed September 2, 2025. https://www.ajmc.com/view/older-white-and-rural-women-remain-at-risk-despite-decline-in-us-ovarian-cancer-mortality-muhammad-faizan-mbbs
5. McCormick B. Ovarian cancer survival gaps persist across racial, ethnic groups. AJMC. May 27, 2025. Accessed September 2, 2025. https://www.ajmc.com/view/ovarian-cancer-survival-gaps-persist-across-racial-ethnic-groups
6. McCormick B. Revealing ovarian cancer survival gaps among Asian American subgroups. AJMC. December 11, 2024. Accessed September 2, 2025. https://www.ajmc.com/view/revealing-ovarian-cancer-survival-gaps-among-asian-american-subgroups
7. McCormick B. Investigators identify factors behind US ovarian cancer mortality disparities, propose targeted solutions. AJMC. August 1, 2025. Accessed September 2, 2025. https://www.ajmc.com/view/investigators-identify-factors-behind-us-ovarian-cancer-mortality-disparities-propose-targeted-solutions