In 2018, there were approximately 22,240 new ovarian cancer cases and 14,070 deaths in the United States. The American Cancer Society analyzed incidence and mortality data from nationwide registries and the National Center for Health Statistics. Overall, ovarian cancer incidence decreased by 29% from 1985 to 2014, and mortality decreased by 33% from 1976 to 2015. Ovarian cancer is heterogeneous, with 90% of cases being epithelial, primarily serous carcinoma. Incidence varies by race/ethnicity, with non-Hispanic whites having the highest rates and non-Hispanic blacks and Asians/Pacific Islanders the lowest. However, APIs have the highest incidence of endometrioid and clear cell carcinomas, which occur at younger ages. Most serous carcinomas are diagnosed at stage III or IV, with 5-year survival rates of 42% and 26%, respectively. Survival rates vary by race/ethnicity, with APIs having the highest survival and NHBs the lowest. Survival has plateaued in NHBs despite improvements in NHWs. Ovarian cancer incidence and mortality have declined due to reduced racial disparities and improved understanding of etiology and tumorigenesis. Early detection strategies remain a research priority, as early-stage ovarian cancer has a 93% 5-year survival rate. Despite these improvements, ovarian cancer remains a significant health issue, with aggressive high-grade serous carcinomas being the most common and having poor survival rates. Risk factors for high-grade serous carcinoma are largely unknown, hindering prevention efforts. Survival rates have improved slightly among NHWs but remain stagnant among NHBs, likely due to differential access to treatment. Further research is needed to address disparities and improve early detection and treatment strategies.In 2018, there were approximately 22,240 new ovarian cancer cases and 14,070 deaths in the United States. The American Cancer Society analyzed incidence and mortality data from nationwide registries and the National Center for Health Statistics. Overall, ovarian cancer incidence decreased by 29% from 1985 to 2014, and mortality decreased by 33% from 1976 to 2015. Ovarian cancer is heterogeneous, with 90% of cases being epithelial, primarily serous carcinoma. Incidence varies by race/ethnicity, with non-Hispanic whites having the highest rates and non-Hispanic blacks and Asians/Pacific Islanders the lowest. However, APIs have the highest incidence of endometrioid and clear cell carcinomas, which occur at younger ages. Most serous carcinomas are diagnosed at stage III or IV, with 5-year survival rates of 42% and 26%, respectively. Survival rates vary by race/ethnicity, with APIs having the highest survival and NHBs the lowest. Survival has plateaued in NHBs despite improvements in NHWs. Ovarian cancer incidence and mortality have declined due to reduced racial disparities and improved understanding of etiology and tumorigenesis. Early detection strategies remain a research priority, as early-stage ovarian cancer has a 93% 5-year survival rate. Despite these improvements, ovarian cancer remains a significant health issue, with aggressive high-grade serous carcinomas being the most common and having poor survival rates. Risk factors for high-grade serous carcinoma are largely unknown, hindering prevention efforts. Survival rates have improved slightly among NHWs but remain stagnant among NHBs, likely due to differential access to treatment. Further research is needed to address disparities and improve early detection and treatment strategies.