Abstract
Background
Ovarian cancer is the fifth most common cancer among females in Brunei Darussalam in 2017. This study aims to provide nationwide cancer statistics including cancer incidence, mortality, survival rates for women diagnosed with epithelial ovarian cancer, and evaluate the prognostic factors of epithelial ovarian cancer patients survival in Brunei Darussalam.
Methods
This is a retrospective population-based study of patients diagnosed with epithelial ovarian cancer between 1st January 2007 and 31st December 2017 in Brunei Darussalam. Crude, age-specific, age-standardized incidence and mortality rates per 100,000 women were calculated. Kaplan-Meier survival analysis method was used to determine the overall 5-years survival rate of epithelial ovarian cancer patients. Log-rank test was used to examine the differences in survival between groups. The Multivariable Cox Proportional Hazard (PH) regression models were used to estimate the hazard ratio (HRs) for overall survival and to identify the prognostic factor of epithelial ovarian cancer patients. PH assumption over time for these models were evaluated.
Results
A total of 207 patients were included in the study. The crude incidence and mortality rates were 9.7 and 3.6 per 100,000 respectively while the age-standardized incidence and mortality rates were 11.3 (95% CI: 9.7, 12.9) and 4.5 (95% CI: 3.4, 5.6) per 100,000 respectively in the period 2007-2017. The overall mean age at diagnosis was 48.4 (standard deviation=15.3) years. The overall survival rates at 1, 3, and 5 years for epithelial ovarian cancer patients were 79.7%, 69.7%, and 61.4% respectively. Age at diagnosis, district, cancer stage, and histology were the significant prognostic factors for epithelial ovarian cancer patients’ survival. Older age at diagnosis (\(\ge\)70 years vs <40 years), regional or advanced stage (vs localized stage) and having undifferentiated or other epithelial ovarian (vs serous carcinoma) were associated with having higher hazard of death while patients residing in Belait district (vs Brunei Muara) was associated with having lower hazard.
Conclusion
More efforts and research should be made to detect the disease at early stage through education and public awareness to ensure the availability of high-quality care for all women with ovarian cancer and to improve the survival rates of patients with ovarian cancer.