Ovarian cancer is a cancer that begins in an ovary. The most common type is epithelial ovarian cancer where cancer begins in the epithelial cells on the outer surface of the ovary. Fallopian tube and peritoneal (lining of abdomen) cancers are often considered to be very similar to ovarian cancer and may represent the same cancer syndrome. There are other rare types of ovarian cancer but most cases, 85%-90%, are epithelial in origin.1,2,3,4
In the United States, the average woman’s lifetime risk for ovarian cancer is 1.2%.5 The median age at diagnosis is 63 years.5 Some hereditary cancer syndromes cause an increased risk for ovarian cancer.1,2,3,6 Up to 24% of ovarian cancers are thought to be due to an inherited risk.7
General Risk Factors
- Beginning menstruation at an early age (before age 12)
- A late age of menopause (after age 55)
- Exposure to estrogen (estrogen-only hormone replacement therapy) after menopause
- Not having children or having children after the age of 35
- Family history of cancer – having family members with ovarian cancer raises the risk of ovarian cancer, even in absence of a known hereditary cause
- Diagnosis of a genetic ovarian cancer predisposition syndrome
Symptoms of ovarian cancer can include abdominal bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, urinary urgency or frequency, fatigue, indigestion, back pain, pain with intercourse, constipation, or menstrual irregularities. These are all symptoms that can be due to medical conditions other than ovarian cancer. If associated with ovarian cancer, these symptoms may occur more often and present differently than what is typical for a particular woman.
In the United States, there is no standard or routine screening test for ovarian cancer in the general population. If your doctor considers you to be at a higher risk than the average person for ovarian cancer due to any of the risk factors mentioned above or if you are experiencing any of the symptoms mentioned above, he or she may recommend that you undergo certain non-diagnostic and non-specific screening tests, which can include a CA-125 blood test (a blood test to measure a marker that can be found at higher levels if ovarian cancer is present but can also be found at higher levels if other conditions are present) or a trans-vaginal ultrasound (this type of ultrasound can be used to view the ovaries.) Other screening tests may include additional types of imaging exams and blood tests. If ovarian cancer is suspected based on the results of any of these exams, your doctor will likely recommend surgery as a next step.
If ovarian cancer is diagnosed during or following surgery, treatment will depend on the stage of the cancer (how far the cancer has grown or spread). Treatment can include some combination of additional surgery, chemotherapy and radiation therapy.
AVOID THE FOLLOWING
- Being very overweight; having too much body fat
- American Society of Clinical Oncology: Ovarian Cancer (http://www.cancer.net/cancer-types/ovarian-cancer)
- American Cancer Society: Ovarian Cancer (http://www.cancer.org/cancer/ovariancancer/index)
- National Cancer Institute: Ovarian Cancer treatment (https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq)
- Erickson BK, Conner MG, Landen CN. The role of the fallopian tube in the origin of ovarian cancer. Am J Obstet Gynecol. 2013 Nov; 209(5): 409–414.
- SEER Cancer Stat Facts: Ovarian Cancer. National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/statfacts/html/ovary.html
- American College of Obstetricians and Gynecologists Committee Opinion No. 716: The role of the obstetrician–gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Obstet Gynecol. 2017 Sept; 130:e146-9.
- Walsh T, et al. Mutations in 12 genes for inherited ovarian, fallopian tube, and peritoneal carcinoma identified by massively parallel sequencing. Proceedings of the National Academy of Sciences of the United States of America. 2011;108(44):18032-18037.
- Easton DF, et al. Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Am J Hum Genet. 1995;56:265-71.