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Sunday, August 18, 2013

What are the risk factors for getting ovarian cancer?

Ovarian cancer is often detected late (stage III and IV) since we do not have effective screening test for it.  As a result, many patients with ovarian cancer died from the disease.  Some of my patients and their family ask me about risk factors that may increase their of ovarian cancer.  These risks may include
  • Older age: ovarian cancer is thought to arise from frequent ovulation.  More ovarian ovulation results in more damage-repair of ovarian cell layer.  Some of the cells may mutate into cancer with time.  Thus, older age is the main risk factor for ovarian cancer
  • Having one or more relatives with ovarian cancer: you may have BRCA genes or other genes that may make you susceptible to cancer.
  • Having abnormalities in a gene, called BRCA1 or BRCA2.  BRCAs are tumor suppressor genes.   These genes make proteins that monitor and suppressor mutation which then lead into cancer.
  • Having genes that are linked to hereditary nonpolyposis colorectal cancer (also called Lynch syndrome).  This mismatch repair genes responsible to multiple cancer mutations that lead to cancers in ovary, colon, uterus, etc.
  • Never being pregnant: that means you ovulate more.
  • Being overweight: may relate to excess estrogen level.
Some factors can reduce your risk of developing ovarian cancer, including:
  • Using hormonal methods of birth control (pills, patch, vaginal ring, injection): these reduces the number of ovulation.  Some studies suggest 50% reduction in ovarian cancer by taking birth control for a few years.
  • Being pregnant, breastfeeding: reduce your life time number of ovulation
  • Having your tubes tied to prevent pregnancy: we think this is related to detecting any abnormalites/precancerous lesion during the tubal ligation procedure or some other unknown effect.
  • Having your uterus or ovaries removed: self explanatory.  Although you may not get ovarian cancer since your ovaries have been removed, but you may still get peritoneal cancer (similar cells to your ovary that line entire internal abdominal and pelvic cavities).

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