Descriptive Features and Incidence Trends in California Cyllene Morris, DVM, PhD California Cancer Registry
Based on morphologic features, epithelial ovarian tumors classified as: Benign Borderline or Low Malignant Potential (LMP) Malignant Still unresolved: are LMP precursors of invasive ovarian cancer (OC) or separate entities? Few serous LMP tumors progress to malignant OC, but some mucinous LMP tumors do.
LMP tumors no longer reportable However LMP tumors included in large screening trials in the US and UK LMP Tumors Still Collected in California
Both staged I – IV (AJCC and FIGO), based on tumor extension (nodes and tumor size do not affect stage) LMP: node Involvement predicts recurrence, but not survival Survival: distant stage LMP ≅ localized OC (excellent prognosis)
Similar epidemiologic features for LMP and invasive OC, except: ◦ LMP: more likely among younger women ◦ BRCA1 – BCRA2 mutations in 24.2% of invasive OC and 4.3% of LMP tumors (2005 Israeli study) ◦ Oral Contraceptives: no protective effect for LMP?
Describe epidemiologic features of LMP tumors compared with invasive OC in California Evaluate incidence trends of LMP tumors by race/ethnicity in the diverse California population
9,433 cases of LMP ovarian tumors diagnosed (as of 03/31/10) Microscopically confirmed Cases detected through autopsy or death certificate only excluded Incidence trends: JoinPoint ( )
LMPInvasive Race/Ethnicity & Age N%N% NH White5, , African American , Hispanic2, , NH Asian/PI , Other/Unknown Race Median Age at DX4663 NH: Non-Hispanic PI: Pacific Islander
LMP: 12.2 cm (4.8 inches) Invasive: 10.6 cm (4.2 inches) P-value < 0.001
Substantial differences between Invasive and LMP tumors: Age-specific rates Race/Ethnicity: Hispanics 24% cases Unlike invasive OC, incidence of LMP tumors among African American and Hispanic women Even though majority of LMP tumors are Stage I, relative survival not 100%, and is lower among African Americans