Demographic and regional trends in ovarian cancer mortality in the United States from 1999 to 2020.

256 Background: Ovarian cancer remains a leading cause of gynecological cancer death in the United States. Despite advances in diagnosis and treatment, overall mortality remains high with limited data on trends for this malignancy. This study examines demographic and regional trends in ovarian cancer mortality by age groups, race, census regions, and census divisions in the United States from 1999 to 2020. Methods: We analyzed mortality data for ovarian cancer (ICD-10 Code C56) from the Centers for Disease Control (CDC) Wonder database for the period of 1999-2020. Age-adjusted mortality rates (AAMRs) per 100,000 people were calculated and stratified by age groups (35-44, 45-54, 55-64, 65-74, 85+), race, census regions, and census divisions. Joinpoint regression analysis was utilized to assess temporal trends, reporting annual percent change (APC) and average annual percent change (AAPC). Statistical significance was defined as p < 0.05. Results: Between 1999 and 2020, ovarian cancer accounted for 313,979 deaths in the United States. While overall mortality from ovarian cancer has decreased during this time, significant disparities in mortality persist. Racial comparisons show that White Americans exhibit higher AAMRs (9.9 in 1999 and 6.4 by 2020) compared to other racial groups (AAPC -2.2%, p < 0.05). Older age groups, especially those aged 85+, suffer higher rates of mortality from ovarian cancer compared to younger age groups, with AAMR decreasing from 37.6 in 1999 to 24.7 in 2020 (AAPC -2.1%, p < 0.05). The Northeast had the highest AAMR, decreasing from 10.3 in 1999 to 6.6 in 2020 (AAPC -2.2%, p < 0.05). The Middle Atlantic region exhibited the highest mortality, with AAMR decreasing from 10.4 in 1999 to 6.7 by 2020 (AAPC -2.1%, p < 0.05). Conclusions: Although ovarian cancer mortality has decreased overall, demographic and regional disparities persist. White Americans, older adults, and residents of the Northeast United States continue to experience a disproportionate burden. Addressing these disparities is essential for further reducing ovarian cancer-related mortality.