Exploring Ovarian Cancer Disparities at the Epidemiological and Molecular Level
Navya Katragadda*, Labdhi Mehta*; Denton Lord, Sarah Mai, Hung Bui, Erin Eroglu; Pankaj Ahluwalia; Ravindra Kolhe
Background
Ovarian cancer is the most lethal gynecologic malignancy in the United States, responsible for ~20,000 new cases and ~12,000 deaths annually. While national mortality rates have declined due to advances in detection and treatment, Georgia continues to show notable regional and population-level differences in incidence and survival, particularly in underserved areas. Understanding these patterns requires integration of epidemiologic surveillance with molecular profiling.
Methods
We analyzed ovarian cancer incidence trends from 2018 to 2022 using the North American Association of Central Cancer Registries (NAACCR) Cancer in North America (CiNA) dataset, comparing Georgia's patterns to national trends and stratifying by race/ethnicity. Tumor-level analyses were performed using The Cancer Genome Atlas—Ovarian Serous Cystadenocarcinoma (TCGA-OV) cohort (minority n=44, non-Hispanic White n=123). Clinical stage distribution was compared across groups, and genomic alterations were assessed using Fisher's exact tests to identify differences in mutation prevalence.
Results
Between 2018 and 2022, ovarian cancer incidence declined by ~1% in Georgia, compared with ~4% nationally. Among non-Hispanic White females, incidence decreased by −6% in both Georgia and the U.S., whereas non-Hispanic Black females experienced a +25% increase in Georgia compared with +4% nationally. In the TCGA-OV cohort, non-Hispanic White patients demonstrated a trend toward more frequent presentation with advanced substage IIIC disease, while minority patients exhibited broader distributions across earlier substages. Genomic analyses revealed several molecular alterations disproportionately enriched in minority patients, suggesting underlying biologic heterogeneity that may contribute to variation in outcomes.
Conclusion
This combined analysis highlights widening differences in ovarian cancer incidence trends and tumor biology within Georgia. Rising incidence among non-Hispanic Black females, coupled with distinct genomic profiles, underscores the importance of integrating population-based data with molecular insights. These findings emphasize the need for targeted strategies to improve ovarian cancer outcomes, including equitable access to care, enhanced early detection, and precision oncology approaches tailored to diverse patient populations.
