Stage

The stage of a cancer describes the extent and pattern of spread, with stage 1 disease confined to the organ of origin and stages 3 and 4 defining disease which has spread to distant organs. Disease staging is fundamental to the management of cancer cases, and all diagnosed cases of ovarian cancer should be staged by the multidisciplinary team (MDT) managing the case. When the patient is too unwell at the time of diagnosis (due to very advanced disease or comorbidities) to undergo full investigations and/or surgery, it may not be possible for the MDT to record stage data.

Stage presented in this report is based on the FIGO 2014 staging system. For more detailed information on staging and its derivation, see Appendix 2. Staging data are reported for all ovary, fallopian tube and primary peritoneal carcinomas, including borderline tumours. See Appendix 1 for a full cohort definition.

Stage data by sub-ICB, ICB and Cancer Alliance and for all of England are available in Table 4 of the accompanying Excel workbook available from the data downloads section.

Figure 5. FIGO stage at diagnosis of ovary, fallopian tube and primary peritoneal carcinomas in England, 2015 to 2019 (Source: CAS AV2020)

The proportion of tumours diagnosed at Stage 1 ranged from 16.1% to 38.4% the 106 sub-ICBs.

Figure 6. Stage at diagnosis of ovary, fallopian tube and primary peritoneal carcinomas by sub-ICB, 2015 to 2019 (Source: CAS AV2020)

There are substantial differences in the stage profile across different geographies. Regional variation in stage data should be interpreted with care. Differences may be driven by how the data has been recorded or by real variation in the profile of cases diagnosed in different regions. Potential explanations for any real variation in stage profiles include differences in diagnostic pathways between regions, varying patterns of the time taken for patients to seek to consult their GP after first experiencing symptoms, inequality in ease of access in primary care to consult a GP for assessment of symptoms, variations in referral practices amongst GPs, and regional differences in primary care access to investigations such as ultrasound.

The proportion of tumours registered with stage recorded ranged from 92.4% to 64.9% amongst the sub-ICBs.

Figure 7. Ovary, fallopian tube and primary peritoneal carcinomas with stage recorded by sub-ICB, 2015 to 2019 (Source: CAS AV2020)

A total of 19.1% of cases considered in this report do not have stage recorded; this varies geographically with up to 35.1% of cases in some sub-ICBs having unknown stage.

The Ovarian Cancer Audit Feasibility Pilot reports the completeness of stage data in the datasets uploaded to the cancer registry by MDTs on a routine basis, with the aim of improving the completeness of this data where this is clinically appropriate.

This information is available to NHS staff via the CancerStats website (this opens in a new window).

Please note that this platform requires an N3/HSCN secure network connection. 

The proportion of tumours diagnosed at early stage (stages 1 and 2) in England was 32.4% and ranged from 27.6% to 54.2% amongst the sub-ICBs.

Figure 8. Ovary, fallopian tube and primary peritoneal carcinomas diagnosed at early or late stage by sub-ICB, 2015 to 2019 (Source: CAS AV2020)

There are substantial differences in the stage profile across different geographies. Potential explanations for this variation include differences in stage completeness, as well as referral and diagnostic pathways.