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19 - Ovarian cancer: prevention, screening, and early detection

from Part IV - Cancer prevention

Published online by Cambridge University Press:  21 August 2009

Jo Ann Rosenfeld
Affiliation:
Johns Hopkins School of Medicine, Baltimore, MD
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
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Summary

Introduction

Despite advances in screening for other forms of cancer, ovarian cancer remains one of the most challenging illnesses encountered in women because of its poor cure rate and minimally available preventive strategies. Seventy per cent of ovarian cancers are discovered when disease has spread beyond the ovaries. Because of late diagnosis and limited long-term survival in stage 3 and 4 disease, the overall five-year survival rate is approximately 30–40%. Ovarian cancer is the leading cause of death from gynecologic malignancies and the fifth leading cause of cancer-associated death in women.

Awareness of ovarian cancer has increased among women. Women seeking routine care, as well as those experiencing pelvic or abdominal pain or diagnosed with a pelvic mass, may be concerned about their risk of cancer. This chapter will address risk factors for ovarian cancer, known and potential prevention strategies, screening methods, early diagnosis, and specific strategies for high-risk populations.

Prevention

Risk factors for ovarian cancer

The risk of ovarian cancer has been linked to overall number of lifetime ovulations, with increasing risk among women of low parity and late menopause and decreasing risk in women using oral contraceptives and in women of high parity. The overall lifetime risk in the general population is 1.6%. These risk factors are unlikely to be of help to the clinician for purposes of screening. However, historical information can be of benefit in delineating women at higher risk for ovarian cancer.

Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
, pp. 311 - 326
Publisher: Cambridge University Press
Print publication year: 2004

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References

Werness, B. A. and Eltabbakh, G. H.Familial ovarian cancer and early ovarian cancer; biologic, pathologic, and clinical features. Int. J. Gynecol. Pathol. 2001; 20:48–63CrossRefGoogle ScholarPubMed
Stratton, J. F., Pharoah, P., Smith, S. K., Easton, B. and Ponder, B. A.A systematic review and meta-analysis of family history and risk of ovarian cancer. Br. J. Obstet. Gynaecol. 1998; 105:493–9CrossRefGoogle ScholarPubMed
Ziogas, A., Gildea, M., Cohen, P., et al.Cancer risk estimates for family members of a population-based family registry for breast and ovarian cancer. Cancer Epidemiol. Biomarkers Prev. 2000; 9:103–11Google ScholarPubMed
Liede, A., Karlan, B. Y., Baldwin, R. L., et al.Cancer incidence in a population of Jewish women at risk of ovarian cancer. J. Clin. Oncol. 2002; 20:1570–77CrossRefGoogle Scholar
Chang, J. and Elledge, R. M.Clinical management of women with genomic BRCA1 and BRCA2 mutations. Breast Cancer Res. Treat. 2001; 69:101–13CrossRefGoogle ScholarPubMed
Galper, S., Gelman, R., Recht, A., et al.Second nonbreast malignancies after conservative surgery and radiation therapy for early-stage breast cancer. Int. J. Radiat. Oncol. Biol. Phys. 2002; 52:406–14CrossRefGoogle ScholarPubMed
Hall, H. I., Jamison, P. and Weir, H. K.Secondary primary ovarian cancer among women diagnosed previously with cancer. Cancer Epidemiol. Biomarkers Prev. 2001; 10:995–9Google Scholar
Marchbanks, P. A., Wilson, H., Bastos, E., et al.Cigarette smoking and epithelial ovarian cancer by histologic type. Obstet. Gynecol. 2000; 95:255–60Google ScholarPubMed
Green, A., Purdie, B., Bain, C., Siskind, V. and Webb, P. M.Cigarette smoking and risk of epithelial ovarian cancer (Australia). Cancer Causes Control 2001; 12:713–19CrossRefGoogle Scholar
Rodriguez, C., Pal, A. V., Calle, E. E., Jacob, E. J. and Thun, M. J.Estrogen replacement therapy and ovarian cancer mortality in a large prospective study of US women. J. Am. Med. Assoc. 2001; 285:1460–65CrossRefGoogle Scholar
Coughlin, S. S., Giustozzi, A., Smith, S. J. and Lee, N. C.A meta-analysis of estrogen replacement therapy and risk of epithelial ovarian cancer. J. Clin. Epidemiol. 2000; 53:367–75CrossRefGoogle ScholarPubMed
Lacey, J. V., Mink, P. J., Lubin, J. H., et al.Menopausal hormone replacement therapy and risk of ovarian cancer. J. Am. Med. Assoc. 2002; 288:334–41CrossRefGoogle ScholarPubMed
Riman, T., Dickman, P. W., Nilsson, S., et al.Risk factors for invasive epithelial ovarian cancer: results from a Swedish case–control study. Am. J. Epidemiol. 2002; 156:363–73CrossRefGoogle ScholarPubMed
Ness, R. B., Cramer, D. W., Goodman, M. T., et al.Infertility, fertility drugs, and cancer: a pooled analysis of case-control studies. Am. J. Epidemiol. 2002; 155:217–24CrossRefGoogle ScholarPubMed
Schildkraut, J. M., Schwingl, P. J., Bastos, E., Evanoff, A. and Hughes, C.Epithelial ovarian cancer risk among women with polycystic ovary syndrome. Obstet. Gynecol. 1996; 88:554–9CrossRefGoogle ScholarPubMed
Balen, A.Polycystic ovary syndrome and cancer. Hum. Reprod. Update 2001; 7:522–5CrossRefGoogle ScholarPubMed
Olson, J. E., Cerhan, J. R., Janney, C. A., et al.Postmenopausal cancer risk after self-reported endometriosis diagnosis in the Iowa Women's Health Study. Cancer 2002; 94:1612–18CrossRefGoogle ScholarPubMed
Modesitt, S. C., Tortolero-Luna, G., Robinson, J. B., Gersehnon, D. M., and Wolf, J. K.Ovarian and extraovarian endometriosis-associated cancer. Obstet. Gynecol. 2002; 100:788–95Google ScholarPubMed
Swiersz, L. M.Role of endometriosis in cancer and tumor development. Ann. N. Y. Acad. Sci. 2002; 955:281–92CrossRefGoogle ScholarPubMed
Parazzini, F., Vecchia, C., Negir, E., et al.Pelvic inflammatory disease and the risk of ovarian cancer. Cancer Epidemiol. Biomarkers Prev. 1996; 5:667–9Google ScholarPubMed
Risch, H. A., and Howe, G. R.Pelvic inflammatory disease and the risk of epithelial ovarian cancer. Cancer Epidemiol. Biomarkers Prev. 1995; 4:447–51Google ScholarPubMed
Wehner, A. P.Cosmetic talc should not be listed as a carcinogen: comments on NTP's deliberations to list talc as a carcinogen. Regul. Toxicol. Pharmacol. 2002; 36:40–50Google ScholarPubMed
Gertig, D. M., Hunter, D. J., Cramer, D. W., et al.Prospective study of talc use and ovarian cancer. J. Natl Cancer Inst. 2000; 92:249–52CrossRefGoogle ScholarPubMed
Shen, N., Weiderpass, E., Antilla, A., et al.Epidemiology of occupational and environmental risk factors related to ovarian cancer. Scand. J. Work Environ. Health 1998; 24:161–4CrossRefGoogle ScholarPubMed
Cass, I., Li, A. J., Runowicz, C. D., et al.Patterns of lymph node metastases in clinically unilateral stage I epithelial ovarian carcinoma. Gynecol. Oncol. 2001; 80:56–61CrossRefGoogle Scholar
Elktabbakh, G. H., Yadev, P. R. and Morgan, A.Clinical picture of women with early stage ovarian cancer. Gynecol. Oncol. 1999; 75:476–9CrossRefGoogle Scholar
Barloon, T. J., Brown, B. P., Monzer, M. A., and Warnock, N.Predictive value of normal endovaginal sonography in excluding disease of the female genital organs and adnexa. J. Ultrasound Med. 1994; 13:395–8CrossRefGoogle ScholarPubMed
Bast, R. C., Xu, F. J., Yu, Y. H., et al.CA125: the past and future. Int. J. Biol. Markers 1998; 13:179–87CrossRefGoogle Scholar
Pauler, D. K., Menon, U., McIntosh, M., et al.Factors influencing serum CA-125 levels in healthy postmenopausal women. Cancer Epidemiol. Biomarkers Prev. 2001; 10:489–93Google ScholarPubMed
Schwartz, P. E.Nongenetic screening of ovarian malignancies. Obstet. Gynecol. Clin. North Am. 2001; 28:637–51,ⅶCrossRefGoogle ScholarPubMed
Simpson, N. K., Johnson, C. C., Ogden, S. L., et al.Recruitment strategies in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial: the first six years. Control. Clin. Trials 2000; 21(6 supp):356–78SCrossRefGoogle ScholarPubMed
Jacobs, I. J., Skates, S. J., Macdonald, N., et al.Screening for ovarian cancer: a pilot randomised controlled trial. Lancet 1999; 353:1207–10CrossRefGoogle ScholarPubMed
Bell, R., Pettigrew, M. and Sheldon, T.The performance of screening tests for ovarian cancer: results of a systematic review. Br. J. Obstet. Gynecol. 1998; 105:1136–47CrossRefGoogle ScholarPubMed
Kim, J. H., Skates, S. J., Uede, T., et al.Osteopontin as a potential diagnostic biomarker for ovarian cancer. J. Am. Med. Assoc. 2002; 287:1671–9CrossRefGoogle ScholarPubMed
Burke, W., Daly, M., Garber, J., et al.Recommendations for follow-up care of individuals with an inherited predisposition to cancer. II: BRCA 1 and BRCA2. J. Am. Med. Assoc. 277:997–1003CrossRef
Laframboise, S., Nedelcu, R., Murphy, J., Cole, D. E., and Rosen, B.Use of CA-125 and ultrasound in high-risk women. Int. J. Gynecol. Cancer 2002; 12:86–91CrossRefGoogle ScholarPubMed
Bosetti, C., Negri, E., Trichopoulos, D., et al.Long-term effects of oral contraceptives on ovarian cancer risk. Int. J. Cancer 2002; 102:262–5CrossRefGoogle ScholarPubMed
Ness, R. B., Grisso, J. A., Klapper, J., et al.Risk of oral contraceptives in relation to estrogen and progestin dose and use characteristics of oral contraceptives. SHARE Study Group. Steroid Hormones and Reproduction. Am. J. Epidemiol. 2000; 152:233–41CrossRefGoogle Scholar
Shildkraut, J. M., Calingaert, B., Marchbanks, P. A., Moorman, P. G. and Rodriguez, G. C.Impact of progestin and estrogen potency in oral contraceptives on ovarian cancer risk. J. Natl Cancer Inst. 2002; 94:32–8CrossRefGoogle Scholar
Piver, M. S.Prophylactic oophorectomy: reducing the U. S. death rate from epithelial ovarian cancer. A continuing debate. Oncologist 1996; 1:326–30Google ScholarPubMed
Siddle, N., Sarrell, P. and Whitehead, M.The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil. Steril. 1987; 47:94–100CrossRefGoogle ScholarPubMed
Watson, N. R., Studd, J. W., Garnett, T., et al.Bone loss after hysterectomy with ovarian conservation. Obstet. Gynecol. 1995; 86:72–7CrossRefGoogle ScholarPubMed
Zhang, M., Binns, C. W. and Lkee, A. H.Tea consumption and ovarian cancer risk: a case control study in China. Cancer Epidemiol. Biomarkers Prev. 2002; 11:713–18Google Scholar
Goodman, M. T., Wu, A. H., Tung, K. H., et al.Association of dairy products, lactose, and calcium with risk of ovarian cancer. Am. J. Epidemiol. 2002; 156:148–57CrossRefGoogle ScholarPubMed
Huncharek, M., Klassen, H. and Kupelnick, B.Dietary beta-carotene intake and the risk of epithelial ovarian cancer: a meta-analysis of 3,782 subjects from five observational studies. In Vivo 2001; 15:339–43Google ScholarPubMed
Cramer, D. W., Kuper, H., Harlow, B. L. and Titus-Ernstoff, L.Carotenoids, antioxidants, and ovarian cancer risk in pre- and postmenopausal women. Int. J. Cancer 2001; 94:128–34CrossRefGoogle ScholarPubMed
Pelucchi, C., Vecchia, C., Chatenoud, L., et al.Dietary fibres and ovarian cancer risk. Eur. J. Cancer 2001; 37:2235–9CrossRefGoogle ScholarPubMed
Rodriguez-Burford, C., Barnes, M. N., Oeschlager, D. K., et al.Effects of nonsteroidal anti-inflammatory agents (NSAIDs) on ovarian carcinoma cell lines: preclinical evaluation of NSAIDs as chemopreventive agents. Clin. Cancer Res. 2002; 8:202–9Google ScholarPubMed
Meier, C. R., Schmitz, S. and Jick, H.Association between acetaminophen or nonsteroidal anti-inflammatory drugs and risk of developing ovarian, breast, or colon cancer. Pharmacotherapy 2002; 22:303–9CrossRefGoogle ScholarPubMed
Vasen, H. F. A., Mecklin, J.-P., Khan, M. P. and Lynch, H. T.The International Collaborative Group on Hereditary Non-Polyposis Colorectal Cancer (ICG-HNPCC). Dis. Colon Rectum 1991; 34:424–5CrossRefGoogle Scholar
Syngal, S., Fox, E. A., Eng, C., et al.Sensitivity and specificity of clinical criteria for hereditary non-polyposis colorectal cancer associated mutations in MSH2 and MLH1. J. Med. Genet. 2000; 37:641–5CrossRefGoogle ScholarPubMed
Peterson, E. A., Milliron, K. J., Lewis, K. E., Goold, S. D. and Merajver, S. D.Health insurance and discrimination concerns and BRCA 1 and 2 testing in a clinic population. Cancer Epidemiol. Biomarkers Prev. 2002; 11:79–87Google Scholar
Scheuer, L., Kauff, N., Robson, M., et al.Outcome of preventive surgery and screening for breast and ovarian cancer in BRCA mutation carriers. J. Clin. Oncol. 2002; 20:1260–68CrossRefGoogle ScholarPubMed
Julian-Reynier, C. M., Bouchard, L. J., Evans, D. G., et al.Women's attitudes toward preventive strategies for hereditary breast or ovarian carcinoma differ from one country to another: differences among English, French, and Canadian women. Cancer 2001; 92:959–683.0.CO;2-V>CrossRefGoogle ScholarPubMed
Narod, S. A., Risch, H., Moslehi, R., et al.Oral contraceptives and the risk of hereditary ovarian cancer. Hereditary Ovarian Cancer Clinical Study Group. N. Engl. J. Med. 1998; 339:424–8CrossRefGoogle ScholarPubMed
Modan, B., Harge, P., Hirsch-Yechezkel, G., et al.Parity, oral contraceptives, and the risk of ovarian cancer among carriers and non-carriers of a BRCA1 or BRCA2 mutation. N. Engl. J. Med. 2001; 345:235–40CrossRefGoogle ScholarPubMed
Lu, K. H., Garber, J. E., Cramer, D. W., et al.Occult ovarian tumors in women with BRCA1 or BRCA2 mutations undergoing prophylactic oophorectomy. J. Clin. Oncol. 2000; 18:2728–32CrossRefGoogle ScholarPubMed
Rebbeck, T. R., Lynch, H. T., Neuhausen, S. L., et al.Prophylactic oophorectomy in carriers of BRCA1 or BRCA 2 mutations. N. Engl. J. Med. 2002; 346:1616–22CrossRefGoogle ScholarPubMed
Roosmalen, M. S., Verhoef, L. C., Stalmeier, P. F., Hoogerbrugge, N. and Daal, W. A.Decision analysis of prophylactic surgery or screening for BRCA1 mutation carriers: a more prominent role for oophorectomy. J. Clin. Oncol. 2002; 20:2092–100CrossRefGoogle ScholarPubMed
Grann, V. R., Jacobson, J. S., Thomason, D., Hershman, D., Heitjan, D. F. and Neugut, A. L.Effect of prevention strategies on survival and quality-adjusted survival of women with BRCA1/2 mutations: an updated decision analysis. J. Clin. Oncol. 2002; 20:2520–29CrossRefGoogle ScholarPubMed
Kuerer, H. M., Hwang, E. S., Anthony, J. P., et al.Current national health insurance coverage policies for breast and ovarian cancer prophylactic surgery. Am. Surg. Oncol. 2000; 7:325–32CrossRefGoogle ScholarPubMed
Hurley, K. E., Miller, S. M., Cosatlas, J. W., Gillespie, D. and Daly, M. B.Anxiety/uncertainty reduction as a motivation for interest in prophylactic oophorectomy in women with a family history of ovarian cancer. J. Womens Health Gend. Based Med. 2001; 10:189–99CrossRefGoogle ScholarPubMed
Tiller, K., Meiser, B., Butow, P., et al.Psychological impact of prophylactic oophorectomy in women at increased risk of developing ovarian cancer: a prospective study. Gynecol. Oncol. 2002; 86:212–19CrossRefGoogle ScholarPubMed
Fry, A, Busby-Earle, C, Rush, R, Cull, A.Prophylactic oophorectomy versus screening: psychosocial outcomes in women at increased risk of ovarian cancer. Psychooncology 2000 May–Jun;10(3): 231–41CrossRefGoogle Scholar

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