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ovarian cancer

ovarian cancer in canada: stats, impact and resources

ovarian cancer rates continue to rise in canada, with medical experts pushing for better prevention techniques to slow growth and improve outcomes.

by karen hawthorne

jul 2 2024

9 minute read

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ovarian cancer doesn’t have the public attention of breast or lung cancer, but there’s growing awareness of ovarian cancer and momentum building in the research community to improve detection and treatment. getty images

everyone born with ovaries has some risk for ovarian cancer, the most lethal reproductive system cancer in canada and around the world. ovarian cancer is a group of distinct cancers that originate at or near the ovaries, the organs that produce eggs in women, or in the fallopian tubes. abnormal cells begin to grow and divide uncontrollably, usually forming a growth or tumour that can spread rapidly through your body.

this cancer is plagued by challenges for unsuspecting women and healthcare providers because there’s no screening test, there’s no diagnostic test, and the symptoms like bloating, fatigue, minor changes to bowel habits, and lower back discomfort are so commonly experienced by women that they’re likely to be dismissed. so, this is a cancer that is often diagnosed in the late stages when the prognosis is grim.

the only way to determine for certain if a growth is ovarian cancer is a biopsy, where a piece of it is removed and examined in a lab.

the most common type, epithelial, is also the most deadly. epithelial ovarian cancer starts in the epithelial cells of the epithelium, the thin outer layer covering the ovary. it’s even more challenging because it’s a high-grade, or fast-growing, cancer that spreads through the body like “grains of sand just moving through the body,” says alison ross, director of knowledge mobilization at ovarian cancer canada, the national non-profit dedicated to funding research and supporting patients . “that’s why it goes undetected for so long and is so hard to remove.”

the standard of care is surgery where possible, followed by chemotherapy that is “like a game of whack-a-mole” because ovarian cancer cells are evolving and not all the same type of cell, which makes targeted chemotherapy less effective, ross explains.

while it doesn’t have the public attention of breast or lung cancer, there’s growing awareness of ovarian cancer and momentum building in the research community to improve detection, treatment and, most importantly, prevention before it starts.

“we have a really robust community dedicated to ovarian cancer,” ross says, adding only a handful of scientists in canada worked on the disease in the 1990s, which has grown to a network of more than 300 across the country today. ovarian cancer canada also works closely with patient partners, a group of 20 women with ovarian cancer who are part of the study teams for research funded by the organization.

“we’re bringing the patient voice forward. so even though a lot of them are sick, they’re undergoing a recurrence, or they’re in active treatment, they’re committed to being part of the research community. i think it’s the people who give me hope.”

ovarian cancer stats in canada

each year, about 3,000 women in canada are diagnosed with ovarian cancer, and 2,000 women will die every year from the disease, according to ovarian cancer canada. those numbers are projected to rise because of our aging and growing population. most cases of epithelial ovarian cancer are found in women who have gone through menopause, so aging is one of the top risk factors. other risks include a family history of ovarian cancer, brca gene mutations (breast cancer genes that increase the risk for breast cancer and ovarian cancer), excess weight, endometriosis, smoking and sedentary behaviour.

sometimes, however, cancer develops in people who don’t have any risks.

health canada gives an overview of projected cases of ovarian cancer that shows the rise in incidence. from 2003 to 2007, the average annual number of new ovarian cancer cases was 2,385. in 2024, that number is now 3,000. elevated incidence rates over the last 20 years were seen most in ontario, whereas the lowest rates appeared in the atlantic region. from the surveillance data from 2003 to 2007, the projected annual number of cases for 2028 to 2032 is expected to increase by 53 per cent to 3,650 as the canadian population grows and ages.

experts say that while breast cancer survival rates, for example, have improved tremendously in the past decade, ovarian cancer patient outcomes haven’t changed in more than 20 years.

the five-year net survival rate was 45 per cent from 2006 to 2008, notes health canada, meaning that 45 per cent of women diagnosed with ovarian cancer will survive for at least five years. that net survival rate is the same today, according to the canadian cancer society .

ovarian cancer is one-tenth as common as breast cancer but three times as lethal, the national institutes of health reports .

impact of ovarian cancer on canadian society

why hasn’t the situation for ovarian cancer patients improved when we have such a renowned medical community in canada? why have life-saving treatments not advanced?

these are questions that members of the society of gynecologic oncology of canada raised in a 2024 submission to the federal standing committee on health about women’s cancers . dr. shannon salvador, the society’s president-elect, who is also program director of the mcgill gynecologic oncology residency program at mcgill university in montreal, writes that funding for clinical care and research has not kept pace with other more common cancers such as colorectal, breast and lung. she points out that women’s cancers have been orphaned from traditional cancer care models as an isolated “women’s issue.” it wasn’t until the 1970s and 1980s that a dedicated group of physicians created the gynecologic oncology sub-specialty to care for women with cancers of the ovary, uterus, cervix, vulva and placenta.

“among all surgical cancer specialties, ours is unique because the care is comprehensive, including diagnosis, surgery, systemic treatments (e.g., chemotherapy), surveillance, and palliative care. only recently has patient care incorporated other disciplines, such as dedicated medical oncologists, radiation oncologists, palliative care teams and specialized nurses have begun collaborating with gynecologic oncology teams,” salvador notes.

with rising numbers of ovarian and other women’s cancers, resources for care are diminishing, and waitlists for gynecologic oncologists and surgical treatments that require specialized medical centres are long. the society calls for increased funding for research and oncology training to grow the much-needed multidisciplinary teams for diagnosis and treatment.

ovarian cancer, like all cancers, is a burden for patients, their families and society with lost income from inability to work, family caregivers who make sacrifices, increased pressure on canada’s healthcare system, and children left without moms.

ovarian cancer canada spearheaded the every woman study to explore patient-reported experiences of ovarian cancer on a national scale, published in current oncology in may 2022 . an online survey conducted in the fall of 2020 included individuals diagnosed with ovarian cancer in canada, reporting responses from 557 women from 11 canadian provinces and territories. the median age at diagnosis was 54, with 61 per cent diagnosed between 2016 and 2020, and 59 per cent of cases were in advanced stage 3 or 4. all subtypes of ovarian cancer were represented. the study flagged a number of issues: lack of awareness about ovarian cancer and its symptoms, patients waiting a month or several months before seeing a doctor about concerns, and patients receiving a diagnosis about three months to a year or more after first consulting a doctor.

the survey also asked how ovarian cancer had impacted the lives of patients, with the vast majority (91 per cent) of respondents highlighting the emotional or psychosocial issues following their diagnosis, like fear of recurrence and fear of dying. coping with treatment-induced menopause and loss of fertility were uniquely challenging for women diagnosed at a younger age, while fear that treatment will not work was more often cited as most challenging for women diagnosed at 50 or older. add to the list of impacts are the post-treatment, long-term side effects, such as debilitating fatigue, anxiety, loss of interest in sex, troubles with cognition, joint pain, sleep loss and muscle pain.

resources and support for ovarian cancer in canada

the leading associations representing ovarian cancer are:

connecting with associations can help patients and their families navigate care, receive one-to-one support, attend virtual education events and join peer support groups. ovarian cancer canada, for example, has a free patient resource guide and other support programs to answer questions and reassure people that “the important thing to know is that you are not alone.”

that’s an essential message in many ways, as science has shown. researchers at the university of utah and huntsman cancer institute found that an ovarian cancer diagnosis took a much higher mental toll on patients and survivors than initially expected at the start of a study in 2021, underscoring the critical need for psychological and emotional support services. “mental health issues are important for cancer patients as they face major disruptions to their lives and deal with the toxic side effects of cancer treatment,” the study’s lead author, siqi hu, told the ovarian cancer research alliance. “however, the risks (for ovarian cancer patients) were far higher and persisted over a longer time period than we expected.”

hu and her team discovered that ovarian cancer patients were more than three times more likely than the general public to be diagnosed with mental health disorders in the first two years after their diagnosis. during those first years, depression, anxiety and adjustment disorder (excessive emotional or behavioural reactions to stress) all posed a risk that was three times higher than for people who did not have ovarian cancer.

the future of ovarian cancer in canada

dr. stephanie lheureux, a leading gynecologic oncologist and researcher at the university health network’s princess margaret cancer centre in toronto, is on the frontlines of change. her research focus is drug development, investigating why patients are resistant to drug therapy treatment and trying to overcome this resistance. she talks about parp inhibitors, a type of targeted cancer drug now used for some women with ovarian cancer. parp is a protein found in cells that helps damaged cells repair themselves, so parp inhibitors work to stop the protein from doing its repair work in cancer cells, and the cell dies. they don’t work for everyone, but clinical trials are looking at using these drugs before surgery or in combination with other therapies.

“we are trying to see if we can identify the mechanism of resistance in a timely fashion to actually adapt the treatment. the more we understand, the more we can look at individualized therapy,” says lheureux.

she’s seen progress in the science. in the past, ovarian cancer was treated similarly regardless of the type or specific characteristics. now, the approach is based on specific features of ovarian cancer and a greater understanding of the pathology of the disease.

“biology drives the evolution of ovarian cancer treatment. i think what has changed is how we approach ovarian cancer by knowing more about the different types of ovarian cancer and how we treat them differently,” she explains. the next advancement in the space is genomics, looking at individual patient dna-sequencing data. for example, the most common type, epithelial ovarian cancer, can be distinguished based on specific biomarkers that can help guide treatment.

“it’s just the beginning, and now, with more genomic research coming, we will understand more and work towards personalized therapy. “

lheureux says the other important progress is the investigation related to the origin of ovarian cancer, identifying where the initial precursor lesions start. “this could help with prevention research and potential new strategy for treatment. so, i think the changes are driven by science and patients. there’s still a lot to discover and understand as, unfortunately, ovarian cancer is still diagnosed at the advanced stage.”

experts agree that prevention is a game-changer across the cancer community. ovarian cancer canada has a prevention initiative launching publicly in september. family doctors are the primary audience to make them more aware of ovarian cancer, what to ask patients about their family history and possible symptoms, and appropriate tests and referrals for next steps if there’s any indication of risk.

ross says there’s a general misperception that the pap test screens for ovarian cancer, but it does not, and while early detection research is a huge priority, “the science is just not there yet,” she says. the prevention initiative also includes questions for people to ask their family doctor to come prepared for appointments and stay informed.

“the best thing that can happen right now with the current science that we have is we can prevent ovarian cancer. so, although we can’t screen for it, we can prevent it before it starts.”

karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto as a freelancer, and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

ovarian cancer in canada: stats, impact and resources

ovarian cancer rates continue to rise in canada, with medical experts pushing for better prevention techniques to slow growth and improve outcomes.

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ovarian cancer stats in canada

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the future of ovarian cancer in canada

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ovarian cancer in canada: stats, impact and resources

ovarian cancer rates continue to rise in canada, with medical experts pushing for better prevention techniques to slow growth and improve outcomes.

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