The third output from the Ovarian Cancer Audit Feasibility Pilot (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. Factors investigated include tumour site, tumour morphology, basis of diagnosis, stage at diagnosis, route to diagnosis, age at diagnosis, deprivation quintile, ethnicity, comorbidity, performance status, treatment, whether the trust at diagnosis housed a specialist gynaecological cancer centre, GP to population ratio and Cancer Alliance.
Data from the National Cancer Registration Dataset were used to identify women diagnosed with ovary, fallopian tube and primary peritoneal carcinomas in England between 1st January 2013 and 31st December 2018. Crude and adjusted mortality rates were calculated via mixed effects logistic regression models to estimate the association of factors with short-term mortality in ovarian cancer patients. To examine geographical variation, crude and case-mix adjusted mortality rates for each Cancer Alliance were calculated.
Results from these analyses show that the short-term mortality rate for ovarian, tubal and primary peritoneal cancer patients in England remains high but indicate a modest overall improvement over the last decade compared to previous NCIN publications.
Adjusted 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.
- 14% of women diagnosed with ovarian, tubal and primary peritoneal carcinomas in England between 2013 and 2018 died within 2 months of diagnosis, and 30% died within the first year.
- Women with stage IV disease were 10 times more likely to die within two months than women with stage I disease, after adjustment for other factors. Women for whom stage was unknown were 9.5 times more likely to die within two months, reflecting cases where women have been too ill to even complete the diagnostic process.
- Women living in the most deprived quintile were 50 per cent more likely to die within two months of diagnosis than those in the least deprived.
- Women diagnosed via an emergency presentation were 4 times more likely to die within two months of diagnosis than those diagnosed via the two-week wait referral system.
- Women over 80 were 40 per cent more likely to die within two months than women aged 70-79.
Last edited: 31 March 2022 9:27 am