What CDC Is Doing About Ovarian Cancer

Based on workshops (PDF-50KB) in 2001 and 2002, CDC developed research and public health initiatives for ovarian cancer. CDC also enhances the growing knowledge about ovarian cancer by initiating research projects with partners, colleagues, and national organizations to help identify factors related to early detection of the disease, treatment, and survivorship.

Accomplishments

Studies

• To investigate end-of-life care, CDC completed a study of women who died of ovarian cancer within three managed care organizations. The objective of this study was to describe end-of-life care and factors that may be associated with care for these women. The study consisted of a retrospective medical record review for the 6 months before death from ovarian cancer between 1995 and 2000. Research goals included assessment of—
  • Clinical signs and symptoms during the last 6 months of life and management of these symptoms.
  • Where the women lived during this time period.
  • What type of medical care was used.
  Results from this study have contributed to the understanding of end-of-life care for women dying of ovarian cancer, including pain management, health care utilization, social support, and hospice use.
• To enhance knowledge about ovarian cancer incidence, staging, and treatment patterns and to assess the status of cancer care for ovarian cancer patients, the Ovarian Cancer Treatment Patterns and Outcomes study was funded. It was conducted with data collected through the National Program of Cancer Registries (NPCR), a cancer surveillance program administered by CDC's Division of Cancer Prevention and Control. Three population-based NPCR registries (in Maryland, New York, and California) collected demographic, tumor, treatment, and survival information on ovarian cancer patients diagnosed between 1997 and 2000. The study attempted to determine—
  • What surgical staging and debulking (removal of tumor) was conducted.
  • The specialty of the surgeon performing the procedure.
  • The success of the debulking process.
  In addition, types of chemotherapy and radiation treatments were evaluated, and survival at 1 and 3 years post-diagnosis was assessed. The study collected information on more than 4,000 ovarian cancer patients and provided valuable information for the public health, scientific, and clinical communities on the status of ovarian cancer care.

Research Articles

CDC has published articles disseminated for the public, health professionals, and researchers. For a complete list of citations, see Ovarian Cancer Research.

National Gynecologic Cancer Awareness Campaign

In collaboration with the Department of Health and Human Services' Office on Women's Health, CDC established the Inside Knowledge: Get the Facts About Gynecologic Cancer campaign to increase awareness and knowledge among women and health care providers about the five major gynecologic cancers: cervical, ovarian, uterine, vaginal, and vulvar. This national campaign is supported by the Gynecologic Cancer Education and Awareness Act of 2005, or Johanna's Law, which was unanimously passed by the U.S. House and Senate (109th Congress) in December of 2006, and signed into law by President George W. Bush on January 12, 2007.

National Program of Cancer Registries

CDC's National Program of Cancer Registries (NPCR) collects surveillance data for all cancers, including ovarian and other gynecologic cancers. Data collected through the NPCR often are used by states to create burden assessments that guide program planning, outreach, and education efforts.

Ongoing Work

CDC's ongoing studies related to ovarian cancer include—

• Risk perception, worry, and use of ovarian cancer screening among women at average, elevated, and high risk of ovarian cancer. To examine the determinants of perceived risk and the influence of these determinants on screening behaviors, CDC is conducting a study of approximately 2,000 women at average-, elevated-, and high-risk, who will be selected randomly from enrollees in a managed care organization with a racially diverse population.
• Clinical practice in the follow-up of ovarian masses. This study will search for findings that clinicians could use to differentiate more effectively between women with potentially malignant masses who require immediate surgery and women with benign abnormalities. Set in a managed care organization, the study will investigate the symptoms or other conditions that lead to a diagnosis of an ovarian mass, the radiologic characteristics of masses most likely to be malignant, and the diagnostic pathways commonly followed.
• General practitioners' awareness and adherence to ovarian cancer screening guidelines. This study aims to evaluate physicians' self-reported ovarian cancer screening and testing practices and determine physician awareness of the published guidelines regarding the lack of evidence for routine ovarian cancer screening. The study also assesses physicians' adherence to published guidelines on ovarian cancer screening among a nationally representative sample of practicing primary care physicians and gynecologists.
• Volume of ovarian cancer surgery cases by physician and hospital using state hospital discharge data. This study is one of two efforts focused on investigating the patterns of primary surgical care for ovarian cancer.
• Frequency of symptoms in women 65 years and older with ovarian cancer as compared to a matched cohort of cancer-free women. Symptoms which have been identified previously among ovarian cancer patients have been considered non-specific; however, this analysis will allow a comparison of the frequencies of such symptoms in ovarian cancer cases when compared to the general population of women in the same age group.
• Diagnostic care referral patterns for women with ovarian cancer. Because the impact of specialty training on the earlier evaluation or diagnosis of ovarian cancer symptoms is unclear, CDC is assessing whether women are diagnosed earlier because they have certain symptoms, or because they are more likely to see a gynecologist or other specialist who may be more likely to consider ovarian cancer in the differential diagnosis.
• Relationship between recorded symptoms, time to diagnosis, and ovarian cancer histology: Surveillance, Epidemiology and End Results (SEER) Medicare, 1995–2002. The purpose of this analysis is to explore whether previous findings regarding the prevalence, type, and duration of symptoms among women with early-stage disease holds true for all histological types. Since 5-year relative survival and stage of diagnosis vary by histological type of ovarian cancer, investigating the relationship between specific ovarian cancer histology, reported symptoms, and time to diagnosis will provide information about the potential benefits of earlier detection through better recognition and follow-up of symptoms.
• Patterns of diagnostic care among women being surgically evaluated for ovarian cancer. This study uses data from the SEER program and Medicare claims. Linking these two data sources results in a unique population-based source of information that can be used for an array of epidemiologic and health-services research. This study includes data from 1995 to 2000 for women aged 65 or older who were diagnosed with ovarian cancer.

Additionally, through its National Comprehensive Cancer Control Program (NCCCP), CDC funds ovarian cancer-related projects in several states. These projects are working to develop ovarian cancer health messages for the general public and for health care providers.