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Curr Epidemiol Rep. 2017 Sep;4(3):211-220. doi: 10.1007/s40471-017-0115-y. Epub 2017 Jul 10.

Challenges and Opportunities in Studying the Epidemiology of Ovarian Cancer Subtypes.

Author information

Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Rm 4125, Salt Lake City, Utah, 84112.
Department of Public Health Sciences, University of Virginia, P.O. Box 800765, Charlottesville, Virginia, 22903.
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.


Purpose of review:

Only recently has it become clear that epithelial ovarian cancer (EOC) is comprised of such distinct histotypes--with different cells of origin, morphology, molecular features, epidemiologic factors, clinical features, and survival patterns-that they can be thought of as different diseases sharing an anatomical location. Herein, we review opportunities and challenges in studying EOC heterogeneity.

Recent findings:

The 2014 World Health Organization diagnostic guidelines incorporate accumulated evidence that high- and low-grade serous tumors have different underlying pathogenesis, and that, on the basis of shared molecular features, most high grade tumors, including some previously classified as endometrioid, are now considered to be high-grade serous. At the same time, several studies have reported that high-grade serous EOC, which is the most common histotype, is itself made up of reproducible subtypes discernable by gene expression patterns.


These major advances in understanding set the stage for a new era of research on EOC risk and clinical outcomes with the potential to reduce morbidity and mortality. We highlight the need for multidisciplinary studies with pathology review using the current guidelines, further molecular characterization of the histotypes and subtypes, inclusion of women of diverse racial/ethnic and socioeconomic backgrounds, and updated epidemiologic and clinical data relevant to current generations of women at risk of EOC.


Epithelial ovarian cancer; gene expression subtype; histotype; pathology; survival

Conflict of interest statement

Conflict of Interest Jennifer Anne Doherty, Lauren Cole Peres, Chen Wang, and Gregory P. Way each declare no potential conflicts of interest. Casey S. Greene reports grants from Gordon and Betty Moore Foundation during the conduct of the study and personal fees from SomaLogic outside the submitted work. Joellen M. Schildkraut reports grants from National Cancer Institute during the conduct of the study.

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