Incidence

There were 6,902 diagnoses of ovary, fallopian tube and primary peritoneal carcinomas per year on average in England in 2015 to 2017 (20,707 over the 3-year period), including tumours with borderline malignant potential. The overall crude incidence rate for the period was 24.7 cases per 100,000 person-years. See Appendix 1 for cohort definition in terms of ICD-10 and ICD-O-2 codes.

Age standardisation was used to enable comparison of Clinical Commissioning Groups (CCGs) with different age profiles. Age standardised incidence rates in the 195 CCGs ranged from 14.5 to 33.9 cases per 100,000 person-years.

Incidence data by CCG, Sustainability and Transformation Partnership (STP) and Cancer Alliance and for all of England are available to download by selecting the download box at the bottom of this page. 

Figure 1. Ovary, fallopian tube and primary peritoneal carcinomas: directly age standardised incidence rates by CCG, 2015 to 2017

Each point on the funnel plot represents a geographical area (in this case, CCG). The population of each CCG is presented on the horizontal axis and the (age standardised) incidence rate of ovary, fallopian tube and primary peritoneal carcinomas is shown on the vertical axis. Some random variation in rates between areas is expected, but the estimate of the rate of these cancers is likely to be more precise for a larger area than for a smaller one. This precision level is represented by the ‘funnel’ dashed lines. Points that lie outside of the dashed lines indicate that such variation may not be explained solely by randomness but may be due to real differences in incidence between areas.

Age standardisation was used to enable comparison of Cancer Alliances with different age profiles. Age standardised incidence rates in the 19 Cancer Alliances ranged from 21.8 to 27.5 cases per 100,000 person-years.

Figure 2. Ovary, fallopian tube and primary peritoneal carcinomas: directly age standardised incidence rates by Cancer Alliance, 2015 to 2017

These funnel plots show unexpected variation in incidence of ovary, fallopian tube and primary peritoneal carcinomas among local geographies (identified by Clinical Commissioning Groups) and regional geographies (identified by Cancer Alliances).  Previously it has been thought that regional variation in incidence may reflect differences in the methods and conventions used for distinguishing between ovary, fallopian tube and primary peritoneal carcinomas at diagnosis. However the new methodology, which includes all of these diseases in the analysis, avoids this as a confounding factor. Age standardisation removes the impact of differences in population age profile on incidence rates, but variation in ethnicity and regional variation in other disease risk factors such as use of hormonal contraception could impact on these data.

The crude incidence rate of ovary, fallopian tube and primary peritoneal carcinomas in England has fluctuated at around 25 cases per 100,000 women between 2001 and 2017. The crude rate in 2001 was 25.4 cases per 100,000 women and in 2017 it was observed to be 24.3 cases per 100,000 women.

Figure 3. Crude rate of ovary, fallopian tube and primary peritoneal carcinomas in England, 2001 to 2017 (Source: CAS AV1907 and ONS2017) 

There is no significant trend in ovary, fallopian tube and primary peritoneal carcinomas incidence over the period 2001 – 2017.