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Ovarian cancer remains to have relatively poor prognosis particularly in low-resourced settings. It is therefore important to continually examine the burden of ovarian cancer to identify areas of disparities. Our study aims to provide an overview of the global burden of ovarian cancer using the GLOBOCAN 2020 estimates by country, world region, and Human Development Index (HDI) levels, as well as the predicted future burden by the year 2040 by HDI. Age-standardized incidence and mortality rates for ovarian cancer in 185 countries were calculated by country, world region, and for the four-tier HDI. The number of new cases and deaths were projected for the year 2040 based on demographic projections by HDI category. Approximately 314 000 new ovarian cancer cases and 207 000 deaths occurred in 2020. There were marked geographic variations in incidence rates, with the highest rates observed in European countries with very high HDI and low rates were found in African countries within the lowest HDI group. Comparable mortality rates were observed across the four-tier HDI. Relative to 2020 estimates, our projection for 2040 indicates approximately 96% and 100% increase in new ovarian cancer cases and deaths, respectively, among low HDI countries compared to 19% and 28% in very high HDI countries. Our study highlights the disproportionate current and future burden of ovarian cancer in countries with lower HDI levels, calling for global action to reduce the burden and inequality of ovarian cancer in access to quality cancer care and treatment.

With respect to cervical cancer management, Finland and the Netherlands are comparable in relevant characteristics, e.g., fertility rate, age-of-mother at first birth and a national screening programme for several years. The aim of this study is to compare trends in incidence of and mortality from cervical cancer in Finland and the Netherlands in relation to the introduction and intensity of the screening programmes. Therefore, incidence and mortality rates were calculated using the Cancer Registries of Finland and the Netherlands. Data on screening intensity were obtained from the Finnish Cancer Registry and the Dutch evaluation centre at ErasmusMC-Rotterdam. Women aged 30-60 have been screened every 5 years, in Finland since 1992 and in the Netherlands since 1996. Screening protocols for smear taking and referral to the gynaecologist are comparable. Incidence and mortality rates have declined more in Finland. In 2003, age-adjusted incidence and mortality in Finland were 4.0 and 0.9 and in the Netherlands 4.9 and 1.4 per 100,000 woman-years, respectively. Excess smear use in the Netherlands was estimated to be 24 per 1,000 women during a 5-year interval compared to 121 in Finland. The decline in mortality in Finland seems to be almost completely related to the screening programme whereas in the Netherlands it was initially considered to be a natural decline. Differences in risk factors might also play a role: the Netherlands has higher population density and higher percentages of immigrants and (female) smokers. The greater excess smear use in Finland might also have affected incidence. (c) 2007 Wiley-Liss, Inc.

Incidence of cancer may vary within a country and over time because of previous differences in exposure to risk factors or interventions for early detection (screening). This study describes time-space trends of incidence of common cancer sites across the Netherlands during the period 1989-2003 and speculates on the reasons for the observations. From the Netherlands Cancer Registry, World standardized incidence rates per municipality were smoothed calculating weighted averages for each 2 km by 2 km grid of the population mid-points of neighbouring municipalities and presented as map animations. Spatial relative changes in incidence were estimated by comparing the periods 1989-1994 and 1998-2003. Complete time-space trends can be found as map animations on http://maps.ikcnet.nl. The incidence of cervical and stomach cancer (for both sexes) decreased, being higher in the cities than in the rural areas during all periods and contrasting the trends in colorectal and breast cancer. The relative increase in incidence of lung cancer among females was highest in the rural north, but the incidence remained higher in the cities of the mid-west Netherlands. For males, there was a marked decrease in lung cancer incidence across the country since 1991. Incidence of melanoma increased, rates being twice as high in the coastal area than in the cities. Prostate cancer maps largely replicated the known history of PSA-testing in the Netherlands. Time-space cancer incidence patterns gave insight into effects of changes in exposure to risk determinants and early detection. The maps illustrate marked potential for cancer prevention at the national and regional level. (C) 2008 Wiley-Liss, Inc.