Patients with risk factor(s) of ovarian cancer may have an increased chance of getting the disease. However, apart from aging and the onset of menopause among women, factors which increase the risk of a woman acquiring epithelial ovarian carcinoma include: reproductive history, family history of certain types of cancer, the occurrence of breast cancer in the past, and the use of fertility drugs, talcum powder, and hormone replacement therapy.
Researchers have noted a possible connection between the number of a woman’s menstrual cycles in her lifetime and the chances of developing cancer in the ovaries. A woman who began menstruating before 12 years old, who gave birth after 30 years of age, or who experienced menopause after 50 years of age, or a combination of these, may be at increased risk of developing the disease.
The history of cancer in the family and the patient is another important risk factor. Women who have had breast cancer are at risk of contracting ovarian cancer, as are women whose female relatives have had ovarian cancer, especially if these occurred at a young age.
The risk of contracting ovarian cancer can be inherited from both the mother’s and the father’s side of the family. About 5% of all ovarian cancers can be traced to hereditary factors. A family history of cancer due to mutations of breast and colorectal cancer increases a woman’s risk of developing ovarian cancer.
Using the fertility drug clomiphene citrate for a prolonged period may also increase the risk of developing ovarian cancer, especially if such use does not lead to pregnancy. Such usage may even result in the development of LMP tumors. It should be noted, however, that infertility, with or without the use of fertility drugs, increases the risk of ovarian cancer.
Using talcum powder, especially in the genital area, has also been suggested as a possible cause of ovarian cancer. This connection was suggested in the past since talcum powder had at times been contaminated with asbestos, a known carcinogen. This alleged link, however, has not been actually proven. Moreover, powder products for the face and body have been required by law for more than 20 years to be asbestos-free.
In addition, some research has suggested that women who use estrogens after menopause (hormone replacement therapy) might run the risk of developing ovarian cancer. These studies remain inconclusive, however, in the light of other research studies that have found such therapy to have no effect on ovarian cancer risk. Due to the different research results, the decision as to whether to have hormone replacement therapy is best left to the woman and her doctor after they have weighed the possible benefits against the risks, which include diseases other than ovarian cancer.
These risk factors only partly explain the occurrence of the disease. Most cases happen in women without any known risk factors. Even so there are ways of reducing the risk of developing epithelial ovarian carcinoma, albeit slightly. These include:
· Tubal ligation, or the process of “tying” the fallopian tubes to prevent pregnancy, when done after child-bearing;
· Hysterectomy, or removal of the uterus. Should a hysterectomy be undertaken for a valid medical reason, removal of the ovaries as well should be carefully considered, especially for women who are either post-menopausal or approaching menopause, or who are over 40 years old;
· The use of oral contraceptives. Research has found that women who have used oral contraceptives for more than five years are about 60% less likely to develop ovarian cancer than women who have never used oral contraceptives;
· Diet. While the impact of diet remains unclear, there are benefits to a diet derived mostly from plant sources and a limited intake of foods that are high in fat, particularly animal fat;
· Genetic counseling and testing, especially for women with a family history of ovarian cancer. This can help determine whether a woman is likely to possess any of the gene mutations associated with ovarian cancer. Genetic testing, however, should be undertaken only after its benefits and possible drawbacks have been carefully considered, and
· Having one or more children before the age of 30 and prolonged breast-feeding. This may reduce the risk slightly, but making such decisions for the sole purpose of reducing the risk of ovarian cancer, is not recommended, especially since protection from the disease is not guaranteed.
It should be noted that none of these measures eliminate the risk of cancer. Even in cases where the ovaries have been removed, cancer may still develop in the pelvic cavity where the ovaries were once located.
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Reviewed by:
Jiade J. Lu, M.D.
Diplomate, American Board of Radiology (Radiation Oncology)
Medical Director
The Cancer Information Network
Date Modified: 06/14/04
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