The effect of advances in epithelial ovarian cancer treatment on population mortality.

5540 Background: Epithelial ovarian carcinoma is the most common and progressive subtype of ovarian cancer. Mortality trends based on race remains unclear. Methods: SEER was used to assess epithelial ovarian cancer mortality and relevant deaths from epithelial ovarian cancer to incident cases. Population-level mortality trends were evaluated according to specific causes. In addition, epithelial ovarian cancer incidence and survival was assessed according to calendar year and race. We applied Joinpoint software to evaluate trends in incidence or incidence-based mortality. Results: Age-adjusted incidence of white patients was the highest, followed by Asians and Black patients. Incidence-based mortality of Asian patients was the lowest among all patients, followed by White and Black patients. Incidence-based mortality of all causes of death of epithelial ovarian cancer increased sharply by 65.09% annually from 2000 through 2002, then rose gradually by 9.45% annually from 2002 through 2005, and then increased more slowly annually from 2005 through 2018. Other causes of death of incidence-based mortality displayed similar trends. However, incidence-based mortality of specific ovarian epithelial cancer deaths displayed an annual decrease of 0.08% from 2005 through 2018, following a sharp annual increase of 65.68% from 2000 through 2002 and 6.55% from 2002 through 2005. White patients with epithelial ovarian cancer showed the highest 2-year relative survival, followed by Asians, Black patients and Native Americans, with all patients showing an improved survival rate. Among White patients with epithelial ovarian cancer, incidence increased annually by 1.98% from 2000 through 2011 and then flattened out to an annual increase of 0.03%. Incidence-based mortality of White patients increased sharply by 56.70% annually from 2000 through 2002, then increased slowly by 7.90% annually from 2002 through 2005, and 2.00% annually from 2005 through 2018. Among Asian patients with epithelial ovarian cancer, incidence increased at an annual rate of 2.39% from 2000 through 2018. Incidence-based mortality of Asian patients increased steeply by 78.70% annually from 2000 through 2002, then slowed down to an annual rate of 2.50% from 2002 through 2018. Among Black patients with epithelial ovarian cancer, incidence increased annually by 10.83% from 2000 through 2002 and 2.43% from 2006 through 2016 and declined annually by 0.82% from 2002 through 2006 and by 1.82% from 2016 through 2018. Incidence-based mortality of Black patients displayed a sharp annual increase of 63.70% from 2000 through 2002, then slowed to an annual rate of 1.90% from 2002 through 2018. Conclusions: Incidence-based mortality of specific ovarian epithelial cancer death decreased annually from 2005 through 2018. These results may be related to treatment advances of epithelial ovarian carcinoma, particularly surgical strategy and chemotherapy.