Who
is at Risk for Developing Ovarian Cancer?
Ovarian cancer is the fourth leading cause of cancer-related deaths in
women. As women age, the risk for ovarian cancer increases. Approximately
90 percent of all cases are diagnosed in women age 40 and older with an
average age of 60. Some risk factors for developing ovarian cancer are:
women who have never had children; women who have had their first period
at an early age, or late onset of menopause.
Ovarian cancer is more common in Western industrialized countries, where
women have fewer pregnancies or have pregnancies later in life and where
diets are high in saturated fat. A less commonly known factor is the use
of talc. Talc has been linked to asbestos, a cancer-causing chemical.
When talc is used in the genital area, particles can enter the vagina
and travel to the uterus. In addition, although there has been some controversy
regarding the effects of fertility pills, some studies have shown that
they may increase the risk for ovarian cancer.
Although it is not certain, the frequency of ovulation has been implicated
in ovarian cancer. Ovulation occurs monthly, when the ovaries release
an egg for potential fertilization. Decreased incidence of ovulation reduces
the risk for ovarian cancer. For this reason, women who take oral contraceptives,
have several children, breast-feed or have children before age 30 have
some protection against ovarian cancer.
The incidence of ovarian cancer is highest among women who have a family
history-at least two family members-of ovarian or breast cancer. About
10 percent of women with ovarian cancer have a family member, either a
first- or second-degree relative, who has had this type of cancer. A first-degree
relative includes a mother or sister, while a second-degree relative includes
a grandmother or aunt. Women with a strong familial occurrence of
ovarian cancer have a 35 to 50 percent risk of developing ovarian cancer.
In these families, ovarian cancer often develops at younger ages (under
age 60). In addition, the risk increases if any male family member has
developed breast cancer or if a family member developed cancer at a young
age.
These family-linked conditions are often found in families with ovarian
cancer alone or with a clustering of both breast and ovarian cancer. In
other cases, a woman may come from a family with Lynch syndrome II. However,
the vast majority of ovarian cancers are not hereditary. A woman in the
general population without genetic risk factors has about a 1 to 2 percent
risk for developing this type of cancer in her lifetime. Genetic predispositions
for developing cancer can also occur within distinct ethnicities such
as in Ashkenazi women. Recent studies have discovered a genetic mutation
among the Ashkenazi Jewish population that predisposes women to ovarian
cancer and other illnesses. When compared with women in the general population,
Ashkenazi women have the highest chance of developing ovarian cancer.
About 10 percent of all ovarian cancers are thought to be hereditary,
or due to a genetic mutation. Genetic mutations in genes that increase
a woman's risk for ovarian cancer, BRCA1 and BRCA2, also predispose a
woman to breast cancer. In women carrying these genes, there is a 44 percent
risk of developing ovarian cancer and an 82 percent risk of developing
breast cancer by age 70. Women carrying these genes should be followed
closely by their physicians. Genetic counseling and testing are advised,
so that risks can be assessed and surveillance recommendations and surgical
options can be discussed. Testing for these genes is available at genetic
testing labs throughout the Continuum system, along with professional
counseling and support.