Dramatic decline in ovarian cancer deaths ‘due to more women taking the contraceptive Pill’

Fewer women across the world are dying from ovarian cancer, new figures today reveal.

The falling death rates are thanks to more women using the contraceptive Pill and a drop in the number of women undergoing hormone replacement therapy during the menopause.

Experts at the University of Milan predict the trend is likely to continue, estimating ovarian death rates in the US and Europe will fall by 15 and 10 per cent respectively by 2020.

Professor Carlo La Vecchia who led the study said while the use of oral contraceptives is the main reason for the falling death rates, a decline in HRT to manage menopausal symptoms and better diagnosis and treatment may also play a role.

Researchers used data from the World Health Organisation relating to deaths from ovarian cancer dating from 1970 to the most recent available year.

They found that in the 28 countries of the EU death rates fell by 10 per cent between 2002 and 2012, from 5.76 per 100,000 women to 5.19.

In the US the decline was even greater, with a 16 per cent drop in death rates from 5.76 per 100,000 in 2002 to 4.85 in 2012.

In Canada ovarian cancer death rates fell over the same period by nearly eight per cent, and in Japan the death rate fell by two per cent.

Large decreases were also noted in Australia and New Zealand.

However, in some parts of the world the pattern of declining death rates was inconsistent - for example, in Latin American countries and in Europe.

Among European countries, the percentage decreases ranged from 0.6 per cent in Hungary to more than 28 per cent in Estonia, while Bulgaria was the only European country to show an apparent increase.

In the UK there was a 22 per cent decrease, while in Austria rates fell by 18 per cent, and that figure was 24 per cent for Denmark and Sweden.

The Latin American countries tended to have lower rates of deaths from ovarian cancer. Argentina, Chile and Uruguay showed decreases between 2002 and 2012, but Brazil, Colombia, Cuba, Mexico and Venezuela all showed increases in death rates.

Professor La Vecchia said: "The large variations in death rates between European countries have reduced since the 1990s when there was a threefold variation across Europe from 3.6 per 100,000 in Portugal to 9.3 in Denmark.

"This is likely to be due to more uniform use of oral contraceptives across the continent, as well as reproductive factors, such as how many children a woman has.

This [falling death rate] is likely to be due to more uniform use of oral contraceptives across the continent, as well as reproductive factors, such as how many children a woman has

Professor Carlo La VecchiaUniversity of Milan

"However, there are still noticeable differences between countries such as Britain, Sweden and Denmark, where more women started to take oral contraceptives earlier - from the 1960s onwards - and countries in Eastern Europe, but also in some other Western and Southern European countries such as Spain, Italy and Greece, where oral contraceptive use started much later and was less widespread.

"This mixed pattern in Europe also helps to explain the difference in the size of the decrease in ovarian cancer deaths between the EU and the USA, as many American women also started to use oral contraceptives earlier.

"Japan, where deaths from ovarian cancer have traditionally been low, now has higher rates in the young than the USA or the EU - again, reflecting infrequent oral contraceptive use."

Another researcher, Dr Eva Negri, added: "Women in countries such as Germany, the UK and the USA were also more likely to use hormone replacement therapy to manage menopausal symptoms than in some other countries.

"The use of HRT declined after the report from the Women's Health Initiative in 2002 highlighted the increased risk of cardiovascular disease, as well as breast and ovarian cancer, and so this may also help to explain the fall in death rates among middle-aged and older women in these countries."

The researchers predict ovarian cancer deaths will be cut by 15 per cent in the US between now and 2020, and they estimate that figure will be a 10 per cent fall in the EU and Japan.

Professor Paolo Boffetta, the Annals of Oncology associate editor for epidemiology, who did not take part in the research, said: "The findings of Professor La Vecchia and his colleagues are important as they show how past use of hormone treatments has an impact on the mortality from ovarian cancer at the population level.

"As our understanding of preventable causes of this major cancer progresses, early detection strategies are being developed and novel therapeutic options become available, we enhance our ability to reduce ovarian cancer mortality."

The new findings are published in the Annals of Oncology today.