Ovarian Cancer Survival Gaps Persist Across Racial, Ethnic Groups

Although non-Hispanic Asian or Pacific Islander populations had the lowest overall ovarian cancer mortality rate, disaggregated data revealed subgroup disparities, according to 2 abstracts published ahead of the 2025 American Society of Clinical Oncology Annual Meeting, underscoring the importance of recognizing the diversity within this racial group.^1,2

Abstracts published ahead of the 2025 American Society of Clinical Oncology Annual Meeting found persistent ovarian cancer survival disparities among racial and ethnic subgroups, particularly within disaggregated Asian American, Native Hawaiian, and Pacific Islander populations. | Image Credit: Dzmitry - stock.adobe.com

Racial, Age Disparities Persist Despite Decline in Ovarian Cancer Mortality

Despite being the second most common gynecological cancer in the US, ovarian cancer causes the highest mortality among all female reproductive tract cancers, according to the authors of the abstract, “Mortality from Ovarian Cancer in Women of the United States: A 21-year Analysis of Trends and Disparities”.¹ Consequently, the study aimed to examine trends in ovarian cancer–related deaths in the US from 1999 to 2020.

The researchers used the CDC Wide-Ranging Online Data for Epidemiologic Research database to examine death certificate data over the 21-year period. They identified female patients with malignant neoplasm of the ovary (International Classification of Diseases, 10^th Edition, code C56), stratifying the data by race/ethnicity, age group, place of death, region, and urbanization.

Using Jointpoint regression analysis, the researchers assessed temporal trends by calculating age-adjusted mortality rates (AAMRs) per 100,000 individuals, along with 95% CIs and annual percent changes (APCs).

Between 1999 and 2020, 338,215 women in the US died from ovarian cancer, with an overall AAMR of 8.32 per 100,000 individuals (95% CI, 8.18-8.45). The AAMR in 1999 was 9.48 per 100,000 individuals, which increased slightly until 2003 (APC, 0.41; 95% CI, –0.54 to 1.86). By 2020, the AAMR declined to 6.55 per 100,000 individuals (APC, –2.28; 95% CI, –2.41 to –2.16).

The researchers highlighted significant racial disparities among AAMRs. Non-Hispanic White patients had the highest AAMR (8.64 per 100,000 individuals), followed by non-Hispanic Black patients (7.08 per 100,000 individuals), non-Hispanic American Indians/Alaska Natives (5.31 per 100,000 individuals), and non-Hispanic Asian or Pacific Islanders (4.96 per 100,000 individuals).

Also, age-stratified data showed that patients aged 65 and older had the highest AAMR (43.09 per 100,000 individuals), followed by those aged 45 to 64 (11.25 per 100,000 individuals) and those aged 25 to 44 (1.20 per 100,000 individuals).

Geographically, AAMRs varied little by census region, with the highest rate in the Northeast (8.55 per 100,000 individuals). Similarly, mortality rates were similar in both metropolitan (8.31 per 100,000 individuals) and non-metropolitan areas (8.38 per 100,000 individuals), with parallel trends observed over time.

Based on these findings, the researchers emphasized the need for targeted interventions.

“Targeted strategies are needed to further prevent mortality from ovarian cancer in high-risk groups, especially dealing with the racial disparities,” the authors wrote.

Ovarian Cancer Survival Disparities Emerge Among Asian American, Native Hawaiian, and Pacific Islander Subgroups

Although the first abstract found that non-Hispanic Asian or Pacific Islander populations had the lowest ovarian cancer-related AAMR, the researchers of the second abstract, “Survival Disparities in Asian Americans With Epithelial Ovarian Cancer,” emphasized that grouping Asian American, Native Hawaiian, and Pacific Islander populations together masks potential differences in health behaviors and socioeconomic status.²

To uncover these differences, they compared disaggregated ovarian cancer survival outcomes among Asian American, Native Hawaiian, and Pacific Islander women with those of non-Hispanic White women, who served as the reference group. 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. Kaplan-Meier estimates were used to generate survival curves, and multivariate Cox regression models were conducted to assess survival outcomes.

The study included 7803 Asian American, Native Hawaiian, and Pacific Islander patients and 212,441 non-Hispanic White patients. Among the Asian American, Native Hawaiian, and Pacific Islander cohort, 2909 were East Asian, 2455 were Southeast Asian, 1901 were South Asian, and 538 were Native Hawaiian and other Pacific Islanders.

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

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. According to Cox regression models, 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.

Taken together with findings from the previous abstract, the results suggest that while Asian American, Native Hawaiian, and Pacific Islander populations with ovarian cancer may have better overall survival than their non-Hispanic White counterparts, significant disparities emerge when these groups are examined individually. The researchers concluded with a call to action for physicians, researchers, and policymakers to more effectively recognize and address this diversity.

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

References

1. Vemula SSM, Ijaz H, Rahman S, et al. Mortality from ovarian cancer in women of the United States: A 21-year analysis of trends and disparities. Presented at: 2025 ASCO Annual Meeting; May 30-June 3; Chicago, IL. Abstract e17551.
2. Phan M, Hu R, Silberstein P. Survival disparities in Asian Americans with epithelial ovarian cancer. Presented at: 2025 ASCO Annual Meeting; May 30-June 3; Chicago, IL. Abstract e17578.