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Ovarian Cancer

  • Ovarian cancer is the eighth most common cancer among women in the United States

  • Ovarian cancer occurs in 1 in 55 women, at any age, but usually over age 50. Around two-thirds of women with ovarian cancer are 55 or older. The median age at diagnosis for ovarian cancer was 63 years.

  • Approximately 20,000 women are diagnosed with ovarian cancer each year. In 2008, it is estimated that 21,650 women in the United States will be diagnosed with ovarian cancer and 15,520 women will die from the disease.

  • Approximately 174,236 women living in the United States currently have ovarian cancer or have a history of ovarian cancer.

  • Ovarian cancer is the 5th leading cause of cancer death among U.S. women.
  • Lifetime risks:
    • One in 72 women will develop ovarian cancer (lifetime risk).
    • One in 95 women will die from ovarian cancer.
    • A woman’s lifetime risk of developing ovarian cancer is 1.4 percent.
    • A woman’s risk of developing ovarian cancer and dying from it is 1.05 percent.

  • Ovarian cancer has the highest mortality rate of all gynecologic cancers.

  • The overall five-year relative survival rate for all women with ovarian cancer is 46 percent.

  • The survival rate improves greatly to 93 percent if the cancer is diagnosed at an early stage before it has spread. Only 19 percent of ovarian cancer cases are diagnosed at this local stage.

  • Approximately 75 percent of ovarian cancer cases are diagnosed at an advanced stage after the cancer has spread beyond the ovary because the symptoms of ovarian cancer are vague or "silent" and reliable screening tests are not yet available.

  • The five-year survival rate for women with ovarian cancer has not significantly increased in the past 30 years—a mere 8 percent.

  • Despite aggressive surgical intervention and new chemotherapeutic regimens, the overall 5-year survival rate for women with advanced stage ovarian cancer has remained constant over the past 30 years, at approximately 15%.

RISK FACTORS:

  • Researchers have identified certain risk factors that increase a woman's chance of developing ovarian cancer. However, studies also show that most women with these risk factors never develop the disease, while many women who do develop the disease possess no risk factors.

  • The risk factors for ovarian cancer may include:
    • Never having been pregnant.
    • Family or personal history of breast or ovarian cancer. About 7% of ovarian cancer cases have a strong hereditary component. If you have a first degree relative (mother, sister, or daughter) with ovarian cancer, your risk of ovarian cancer increases to 5%; if you have 2 first degree relatives with ovarian cancer your risk becomes 7%.
    • Family or personal history of BRCA-1 or BRCA-2 genetic mutation. In women with BRCA 1 genetic mutations (and to a lesser extent, BRCA-2), risk of ovarian cancer is 16%--44%. These mutations are also associated with earlier onset of the disease.
    • Abdominal obesity.
    • Women who began menstruating before age 12 or reached menopause after age 50.
    • Having had breast cancer, particularly before age 50.

  • Factors that REDUCE ovarian cancer risk:
    • Pregnancy.
    • Breastfeeding.
    • Oophorectomy.
    • Taking birth control pills: The Cancer and Steroid Hormone Study (CASH), the largest investigation to date, found an average 40% decrease in the likelihood of ovarian cancer in women who had ever taken birth control pills. The protective effect was observed with as little as 3 to 6 months of use, and persisted for 15 years beyond discontinuation of the pill. Another study, published in the American Journal of Epidemiology (8/1/00), found that oral contraceptive pills containing lower doses of estrogen and progestin also cut a woman's ovarian cancer risk by 40 percent - the same risk reduction provided by higher dose pills.
    • Exercise may reduce your risk of ovarian cancer by 27%, according to a study in the Journal of Obstetrics and Gynecology

  • Symptoms: The symptoms are generally subtle and vague so that women ignore them. The key is that the symptoms last more than 2-3 weeks and are otherwise unexplained. 90% of women with ovarian cancer reported having some of the following symptoms:
    • Increasing waist line size, for no obvious reason.
    • Digestive problems: gas, flatulence, bloating, loss of appetite, occasionally abdominal pain.
    • Abdominal pressure or discomfort.
    • Changes in bowel and bladder habits (e.g. urinary frequency, diarrhea, constipation).
    • Pain (less common) in the lower back, pelvis or legs.
    • Abnormal vaginal bleeding.
    • Unusual fatigue or backaches.
    • Unexplained weight loss or gain.
    • Shortness of breath.

  • Screening: There is no effective screening test for ovarian cancer. Screening is not recommended for all women, but is recommended for women with symptoms of ovarian cancer and women at high risk (e.g. women with a family history or women with the BRCA-1 or 2 genetic mutations). However, ovarian abnormalities can be detected on a routine pelvic exam, with a screening vaginal ultrasound, or with a CA-125 blood test. Blood levels of CA-125 are elevated in about 50% of women with early ovarian cancer and about 80% of those with advanced disease. The only way to confirm the diagnosis, however, is with an ovarian biopsy.

Racial Differences:

  • African American women, who have much lower ovarian cancer incidence rates than Caucasian women, are less likely than their Caucasian counterparts to survive five or more years with this disease, regardless of the stage at diagnosis.
  • African American women are more commonly diagnosed with widespread, and therefore advanced stage, ovarian masses than Caucasian women.
  • African American, Hawaiian, and Alaskan native women have overall cancer mortality rates that are at least 40% higher than other minority populations.

Source: Ovarian Cancer National Alliance

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Created: 9/9/2008  -  Donnica Moore, M.D.


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