Ovarian Cancer Audit Feasibility Pilot: Outputs

Disease Profile in England: Incidence, mortality, stage and survival for ovary, fallopian tube and primary peritoneal carcinomas

The first report from the Ovarian Cancer Audit Feasibility Pilot was the Disease Profile, covering incidence, mortality, stage and survival, published January 2020.

Main findings:

  • The incidence rate of ovary, fallopian tube and primary peritoneal carcinomas in England has remained reasonably stable since 2001.
  • Incidence and mortality rates vary among CCGs and Cancer Alliances, with variation beyond what might be expected by random chance, suggesting that there may be genuine differences between areas.
  • The proportions of patients diagnosed at early and late stages vary considerably around the country; some of this variability is likely due to data completeness but other factors should also be considered.
  • Completeness of stage data varies by geography; there is some room for improvement which would lead to better data quality for reporting.
  • Survival of patients with ovary, fallopian tube and primary peritoneal carcinomas has been improving since 2001. Improving one-year survival may reflect progress in diagnosing the disease sooner, with increased awareness of the symptoms amongst women and primary care practitioners, and improved diagnostic pathways, enabling more women to be diagnosed while still well enough to undergo treatment. Increased 5-year survival may reflect improvements in surgical and chemotherapy treatments. Assessment of geographic variation in survival rates may help to identify areas of best practice and improve the outlook for all patients.

PDF report and supporting tables (Figure 1 of PDF report corrected Feb 2020).

Geographic variation in ovarian, fallopian tube and primary peritoneal cancer treatment in England

Given the disparity in ovarian cancer survival highlighted in the first report, this second output looks to see whether some of this variation may be attributable to differences in clinical practice across regions of England.

Results indicate that the probability of accessing surgery and chemotherapy varies across England, even after accounting for differences in patient and tumour characteristics.

These findings indicate an opportunity for identifying examples of best practice that could be disseminated to Cancer Alliances where treatment probabilities are lower, leading to improvements in therapy and better outcomes for women with ovarian cancer. 

The PDF report can be accessed here. Separately, breakdowns of the age, stage and Charlson distribution of tumours within the analytical cohort (Appendix 2) are provided here.

Short-term mortality in ovarian, fallopian tube and primary peritoneal carcinomas across England

The third output from the OCAFP investigates factors associated with mortality in the first year after diagnosis for ovary, fallopian tube and primary peritoneal carcinoma (‘ovarian cancer’) patients diagnosed between 2013 and 2018, and examines to what extent geographical variation occurs at a Cancer Alliance level.

Results from these analyses show that the short-term mortality rate for ovarian, tubal and primary peritoneal carcinoma patients in England remains high but suggests a modest overall improvement over the last decade compared to previous NCIN publications. Crude and adjusted results are reported and indicate that mortality rates were higher for older women, those who were diagnosed at a later or unknown stage of disease, had an unknown morphology, were diagnosed following an emergency presentation or non-urgent route, had a greater burden of comorbidities or resided in an area of low socioeconomic status.

Crude and case-mix adjusted results indicated that some variation in short-term mortality may exist at a Cancer Alliance level, but much of this variation is likely due to different patient case-mix or that while variation may exist at a more local level, this has evened out by the time data is analysed at Alliance level.

The report can be accessed as a PDF file here or as a Word file here. Supporting tables for crude counts and rates of mortality at NHS trust level are also available on CancerStats2.

Data completeness reports

Data completeness reports for certain key data items for ovarian cancer are available to members of gynae-oncology MDTs and other individuals within trusts and cancer alliances who have reason to access the data via CancerStats2. Access can be requested via a button on that page.