Introduction

The Ovarian Cancer Audit Feasibility Pilot (OCAFP) has been a four-year collaboration between the gynaecological oncology clinical community, the charity sector and NHS England (NHSE). Between 2019 and 2023, a range of outputs on ovarian cancer have been reported. The primary objective of the OCAFP has been to explore the feasibility of undertaking meaningful analyses of routinely collected data for the purpose of improving treatment and outcomes for women diagnosed with ovarian cancer in England – the leading cause of gynaecological cancer death for women in the UK.

An additional objective of the collaboration has been to demonstrate the potential for ovarian cancer data analysis to reduce inequalities in health and care provision, supporting calls for a publicly funded national ovarian cancer audit. This ambition was achieved when the Healthcare Quality Improvement Partnership (HQIP) announced a national ovarian cancer audit in 2022.

The methods, successes, limitations, and associated intelligence from the OCAFP should be used to inform the development of the national ovarian cancer audit, which has the potential to extend the achievements of the OCAFP over the coming years. A project summary report was published by NHSE in 2023 and details the methodological successes, challenges and limitations identified during the OCAFP.

The OCAFP has been jointly funded by the British Gynaecological Cancer Society, Target Ovarian Cancer and Ovarian Cancer Action, and delivered by analysts within NHSE’s NDRS.

Find out more about the outputs from the audit on the OCAFP web page. 

The first publication from the OCAFP was the Disease Profile report for ovary, fallopian tube and primary peritoneal carcinomas (‘ovarian cancer’) diagnosed in England. This described incidence, mortality and stage for 201 to 2017 diagnoses, and survival for cases diagnosed 2013 to 2017. Amongst its many findings, the report showed marked geographic variation in cancer survival across England at a Cancer Alliance level.

One hypothesis for such disparity was the possibility of variation in the local clinical management of disease. To explore this, a follow-up report was produced to quantify the extent to which ovarian cancer treatment differed between Cancer Alliances in England, and the degree to which such differences might be explained by variations in tumour and patient characteristics. Results from this Geographic Treatment Variation report analysing cases diagnosed between 2016 and 2018 supported the hypothesis of regional variations in the probability of accessing surgery and chemotherapy across England, even after accounting for differences in patient and tumour characteristics.

Given the importance of these findings, this latest report and final OCAFP output, updates key data from the Disease Profile and Geographic Treatment Variation publications. It begins with updated incidence, mortality, stage and survival results for ovarian cancers diagnosed between 2015 and 2019, before moving on to report regional variation in treatment. This latter set of results focuses on diagnoses made in 2019 only, highlighting more recent disparities in access to treatment. For comparison against the updated survival statistics, treatment variation results are also be reported for the period 2015 to 2019. These updated survival analyses found that one-year net survival for ovary, fallopian tube and primary peritoneal carcinomas (excluding borderline tumours) had increased from 57.6% for 2001 to 2005 diagnoses to 68.4% for 2015 to 2019 diagnoses. Similarly marked improvements were also found for five-year net survival.

The methods and limitations underlying all analyses are included at the end of the report.