Factors known to reduce risk of ovarian and associated cancers Read More
How is ovarian cancer diagnosed and detected? Read More
Is ovarian cancer preventable? Read More

Ovarian Cancer, Fallopian Tube Cancer or Primary Peritoneal Cancer

What are the factors known to raise the chances of getting ovarian cancer?

Symptoms of ovarian cancer are often like ordinarily felt discomfort. One needs to be vigilant of persistent symptoms, which do not get better even after trying normal ways to resolve them.

Research has shed light on factors that may increase the risk for ovarian cancer and as research progresses, our understanding is hoped to improve. Having one or more of the below mentioned risk factors does not mean that one will get cancer. Of note, there is no clear, consistent evidence so far linking factors such as overweight and obesity to risk of ovarian cancer.

I. Age

Overall, age is a major risk factor as ovarian cancer incidence is highest above 60 years of age, mostly developing after menopause. Ovarian cancer is rare in women who are younger than 40.

II. Late or no full-term pregnancy

Women who have had a very late or no full-term pregnancy are at a higher risk

III. Fertility treatment

Undergoing fertility treatment without resulting in pregnancy may slightly increase risk of ovarian cancer. It is however best to talk to one’s doctor to understand this aspect better.

IV. Hormone replacement therapy (HRT) after menopause

Undergoing HRT after menopause may increase ovarian cancer risk slightly, but the risk can drop once she stops HRT.

V. Family and genetic history

Family history can increase risk, with risk coming from both mother’s and father’s side. About one out of 10 ovarian cancer cases is hereditary. A risk in other cancer types such as breast may also increase ovarian cancer risk, because of mutation in common genes involved5. Inherited mutations in genes such as BRCA1 or BRCA2 may increase the risk of cancers including that of ovary as well as breast, fallopian tube, pancreas etc. For every 100 women with a BRCA1 mutation, 35-70 women are more likely to get ovarian cancer. For BRCA2 mutation, this number is 10-30.


What are the symptoms of ovarian cancer?

Symptoms of ovarian cancer may feel like ordinarily felt discomfort. So it is important to be watchful of the severity, frequency and prolongation of symptoms. If they persist, even after normal interventions, one must immediately consult a doctor. Most commonly felt symptoms of ovarian cancer are:

  • feeling bloated always
  • quickly feeling full after eating
  • a feeling to urinate frequently and urgently
  • pain or discomfort in the pelvic area
  • minor symptoms include persistent indigestion or nausea, pain during sex, change in bowel habits, back pain, vaginal bleeding (particularly after menopause), constipation, feeling of tiredness all the time & unexplained weight loss.

One must consult a doctor if these and other unusual symptoms are felt for above one or two weeks.

Abbreviations

AJCC: American Joint Committee on Cancer CT scan: Computed Tomography scan EBRT: External beam radiation therapy FIGO: International Federation of Gynecology and Obstetrics HRT: Hormone replacement therapy LHRH: Luteinizing hormone-releasing hormone NCI: National Cancer Institute PARP: Poly (ADP-ribose) polymerase PET scan: Positron emission tomography scan TNM: Tumor, node, metastasis staging system

References

  1. What is ovarian cancer?, American Cancer Society, Available at: https://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html, Accessed on 15.02.2019
  2. Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68(6), 394-424. doi:10.3322/caac.21492
  3. Timing of Pregnancy and the Risk of Epithelial Ovarian Cancer, David C. Whiteman, Victor Siskind, David M. Purdie and Adèle C. Green, Cancer Epidemiol Biomarkers Prev January 1 2003 (12) (1) 42-46
  4. Loft A, Lidegaard O, Tabor A. (1997). Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up. Br J Obstet Gynaecol, 104(11), 1296-301. Retrieved from https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.1997.tb10978.x
  5. Ovarian Cancer Risk Factors, American Cancer Society, Available at: https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html, Accessed on 18.02.2019
  6. Foong, K. W., & Bolton, H. (2017). Obesity and ovarian cancer risk: A systematic review. Post Reproductive Health, 23(4), 183-198. doi:10.1177/2053369117709225
  7. Stewart, L. M., Holman, C. D., Aboagye-Sarfo, P., Finn, J. C., Preen, D. B., & Hart, R. (2013). In vitro fertilization, endometriosis, nulliparity and ovarian cancer risk. Gynecologic Oncology, 128(2), 260-264. doi:10.1016/j.ygyno.2012.10.023
  8. HRT and Cancer, Cancer Research UK, Available at: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/hrt-and-cancer Accessed on: 18.02.2019
  9. Frank, T. S. (1999). Testing for Hereditary Risk of Ovarian Cancer. Cancer Control, 6(4), 327-334. doi:10.1177/107327489900600401
  10. Symptoms: Ovarian Cancer, National Health Service (NHS), UK, Available at: https://www.nhs.uk/conditions/ovarian-cancer/symptoms/ Accessed on: 18.02.2019
  11. Frank, T. S. (1999). Testing for Hereditary Risk of Ovarian Cancer. Cancer Control, 6(4), 327-334. doi:10.1177/107327489900600401
  12. Ovarian Cancer Stages, American Cancer Society, Available at: https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/staging.html Accessed on 19.02.2019
  13. Treatment, Target Ovarian Cancer, UK, Available at: https://www.targetovariancancer.org.uk/information-and-support/my-ovarian-cancer-has-come-back/treatment Accessed on 12.06.2019