Ovarian Cancer: Risk Factors,screening and Staging

Ovarian cancer ranked as the seventh (7th) most common malignancy in the U.S. in 2002. It was estimated the new cases that year was about 23,000. Approximately 15,280 women in America will die this year because of the disease. It is considered a disease among postmenopausal women between the ages of fifty (50) to eighty (80) years old. The median age at diagnosis is 63 years old. Around two-thirds of women with ovarian cancer are 55 or older. It is slightly more common in white women than African-American women.

Risk factors. Nulliparous women are at higher risk while there is a reduced risk among pregnant women. But aside from age, the most important risk factor is having a strong family history of the disease among one or more first degree relatives. Factors that also increase risk is the use of fertility drugs and use of hormone therapy during late menopause. A decreased risk factors were found in having children along with breast feeding, sustained use of oral contraceptives, bilateral tubal ligation or hysterectomy and prophylactic oophorectomy.

Screening. Although screening does not guarantee in decreasing the risk of dying from ovarian cancer, and annual "rectovaginal pelvic examination" is mandatory for women who falls into the category of an average risk for ovarian cancer. The high risk group can be described as women with one or more first degree relatives with breast or ovarian cancer and those who tested positive for the BRCA- 1 or BRCA- 2 gene mutation. Also, National Institutes of Health highly recommends women with BRCA mutations must undergo annual rectovaginal pelvic examinations, serum - CA- 125 determinations, and transvaginal ultrasound until completion of their child bearing years or until the age of 35 years old.

Staging. It should be noted that patient survival is not only by staging, but also to the amount of residual tumor after tumor debulking (is the surgical removal of "part" of a malignant tumor which cannot be completely excised). Stage I disease is confined to one or both ovaries; Stage II involves spread to the pelvis; Stage III is an intraabdominal spread or peritoneal dissemination, and Stage IV is a spread outside the abdomen or distant metastasis. Finally, it is interesting to note that the anticancer agent tamoxifen have shown therapeutic evidence on clinical trials for refractory ovarian cancer.

For more information visit www.cancer.gov/cancer_information/prevention

On risk of ovarian cancer algorithm study www.epi.grants.cancer.gov/ovarian

On prophylactic bilateral oophorectomy treatment http://consensus.nih.gov/cons/096/096_statement.htm

On debulking ovarian cancer www.ovariancancerresource101.com