Norwegian Gynecological Cancer Registry
Article
|Last update
The incidence of ovarian cancer has shown a decline in recent years for women between 50 and 69 years. The proportion of patients who undergo surgery varies with where the patients live.
Summary from the annual report 2024
Ovarian cancer
Figure 1.1 shows the results of the registry’s quality indicators for ovarian cancer at the national level for 2024. Figure 1.2 shows the quality indicators at the hospital and regional level.
The incidence of ovarian, fallopian tube, and peritoneal cancer (collective term: ovarian cancer) has declined in recent years, particularly among women aged 30–69, while remaining stable for those over 70. Mortality has steadily decreased across all age groups over the past 50 years. Borderline tumors primarily affect younger women (median age 56), whereas ovarian cancer affect older women (median age 70). Most patients experienced symptoms before seeking medical attention.
In 2024, 97,1% of ovarian cancer evaluations included CT/MRI, meeting national targets. However, multidisciplinary team (MDT) meetings were held for 79,9% of cases, falling short of the target. Surgery rates varied by region, with a national average of 68,2%. The Mid region had the highest surgical rates, while the South-Eastern region had the lowest. Specialized hospitals performed 84,4% of surgeries, surpassing the 80% target of centralization.
An essential quality indicator — absence of residual tumor after surgery —was achieved in 88,7% of cases, well above the 65% target. Chemotherapy practices varied slightly at stage I but were more consistent at stages II-IV. The median time from surgery to chemotherapy was 30 days (23 days after neoadjuvant treatment).
Postoperative mortality within 30 days was 0,1% (below the 2% target), while one-year mortality after surgery was 6,2%. Five-year survival has improved from 30,6% in 1980 to 49,8% in 2024, though some regional differences remain.
Cervical cancer
Figure 1.3 shows an overview of the registry’s quality indicators for cervical cancer at national level for 2024, while figure 1.4 shows the indicators at the regional level.
The incidence of cervical cancer in Norway has steadily decreased in the period from 1970 to the present, with the exception of a period from 2005-2020 where we can see a small increase in incidence in some of the age groups. The median age in 2024 was 50 years. The majority of the women had symptoms before going to the doctor (54,7%).
MRI of the pelvis was included in the evaluation of 91,3% of the patients, meeting the national target of 90%.
Nationally, 84,0% of patients received PET before radiotherapy in 2024, none of the health regions achieved the target of minimum 95%. 75,5% of the patients were diagnosed with squamous cell carcinoma, while 18,5% had adenocarcinoma.
Over the past three years 54,0% of the patients had surgery, either with conization or hysterectomy (removal of the uterus), while 42,5% of patients were given radiotherapy. 98,1% of the patients completed their radiotherapy within 50 days in 2024.
The indicator target, set at a minimum of 95%, is thus achieved nationally.The proportion of patients treated with radiation who received concomitant (simultaneous) chemotherapy was 87,0% in 2024.
Mortality has decreased for all age groups over the past 50 years. 5-year relative survival for cervical cancer has increased steadily over the past 45 years (from 70,8% in 1980 to 82,7% in 2024).
Endometrial cancer
Endometrial cancer was included in the quality register in 2024 and this is the first annual report to present results. No quality indicators have yet been defined for endometrial cancer.
The incidence of endometrial cancer in Norway shows a slight increase from 1970 to the present. The increase is greatest in the oldest age groups (+70 years). The median age at diagnosis in 2024 was 70 years.
Nationally, 50,6% of the endometrial cancer patients had multidisciplinary team (MDT) meetings in 2024. The results suggest differences among the health regions. The morphological type is dominated by endometrioid carcinomas, which constitute 75,8% of the patients.
The proportion of all endometrial cancer patients who had surgery in 2024 was 86,0%. Of those operated on, 80,5% had minimally invasive surgery and 54,7% had lymph node resection done. The median time from surgery to the start of chemotherapy was 36 days. Some variation was found among the health regions.
The age-standardized mortality rate for endometrial cancer has remained quite stable since 1970. Few patients die postoperatively. Nationally, only 0,1% died within 30 days after surgery in the period 2022–2024.The 5-year relative survival has increased from 71,3% in 1980 to 86,8% in 2024