[Pattern of mortality from ovarian cancer in France 1968-1991]

In a recent meta-analysis of three American case-control studies, Whittermore et al found an increased risk of ovarian cancer in women treated for infertility. We have studied the mortality due to ovarian cancer in France between 1968 and 1991 in order to verify whether the use of these treatments could have modified mortality rates during the 24 years period studied. First, we have noted that among the 3175 deaths from ovarian cancer registered in France in 1991, only 136 occurred in women under 45 years of age, and 943 occurred in women between 45 and 59 years of age. We then observed an important geographical diversity with a higher frequency of ovarian cancer in the North of France as compared to the South. Finally, we observed a 72% increase in mortality during the study period. This increase can be entirely explained by the increase in the mortality rates among women over 60 years of age. Among women under 45, the ovarian cancer rate decreased by 24% between 1968 and 1991. Among women between 45 and 59 years of age, these rates increased by only 8% (or about 0.3% per year). These results imply that a possible effect--in terms of public health--of treatment for infertility does not necessarily translate into a significant increase in mortality from ovarian cancer among women under 60 years of age. This result in no way nullifies the role that epidemiological studies have in verifying the accuracy of risks associated with treatments for infertility.