Racial disparities in ovarian cancer incidence and mortality in Brazil: a population based analysis

Abstract

This study aimed to assess racial disparities in the incidence and mortality of ovarian cancer in Brazil. Data were obtained from three national sources: the Population-Based Cancer Registries (2010–2017), the Hospital-Based Cancer Registries, and the Mortality Information System (2000–2023). Crude and age-adjusted rates per 100,000 women were calculated by race (White vs. Black/Brown). Temporal trends were analyzed using Joinpoint regression, estimating the Annual Percent Change (APC). From 2010–2017, a total of 19,186 incident ovarian cancer cases were recorded, of which 61.9% occurred in White and 30.1% in Black/Brown women. Incidence rates declined among White women (APC –2.36%, p = 0.007) but remained stable among Black/Brown women (APC + 1.77%, p = 0.47). From 2000–2023, mortality increased among Black/Brown women (+1.85%/year, p < 0.001) and remained stable among White women (+0.11%/year, p = 0.39). Hospital-based data (n = 40,762) showed that Black/Brown women were younger (64.4% <60 years), less educated (55.6% <8 years), and more often lived in the Northeast region (53.2%). Compared with White women, they were less frequently staged at diagnosis (49.4% vs. 43.0%, p < 0.001), had longer delays to treatment initiation (≥60 days: 8.3% vs. 6.5%, p < 0.001), and higher early mortality rates (21.4% vs. 19.0%, p < 0.001). While ovarian cancer incidence is declining among White Brazilian women, Black/Brown women experience stable incidence and rising mortality. Socioeconomic vulnerability, regional disparities, and delays in treatment—rather than biological differences—appear to drive this gap. Implementing targeted policies to ensure equitable access to timely diagnosis and optimal care is essential to reduce these avoidable inequalities.