Ovarian cancer: prevention, screening, and early detection

Jo Ann Rosenfeld

doi:10.1017/CBO9780511545672.019

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

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Jo Ann Rosenfeld

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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.

Keywords

BRCA1 BRCA2 chemoprevention genetic counseling prophylactic oophorectomy prophylactic surgery ovarian cancer

Type: Chapter
Information: Women's Health in Mid-Life
A Primary Care Guide
, pp. 311 - 326

DOI: https://doi.org/10.1017/CBO9780511545672.019 [Opens in a new window]

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; 20:48–63CrossRef Google Scholar PubMed

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; 105:493–9CrossRef Google Scholar PubMed

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 Scholar PubMed

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; 20:1570–77CrossRef Google Scholar

Chang, J. and Elledge, R. M.Clinical management of women with genomic BRCA1 and BRCA2 mutations. Breast Cancer Res. Treat. 2001; 69:101–13CrossRef Google Scholar PubMed

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; 52:406–14CrossRef Google Scholar PubMed

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 Scholar PubMed

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; 12:713–19CrossRef Google 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; 285:1460–65CrossRef Google 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; 53:367–75CrossRef Google Scholar PubMed

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; 288:334–41CrossRef Google Scholar PubMed

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; 156:363–73CrossRef Google Scholar PubMed

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; 155:217–24CrossRef Google Scholar PubMed

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; 88:554–9CrossRef Google Scholar PubMed

Balen, A.Polycystic ovary syndrome and cancer. Hum. Reprod. Update 2001; 7:522–5CrossRef Google Scholar PubMed

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; 94:1612–18CrossRef Google Scholar PubMed

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 Scholar PubMed

Swiersz, L. M.Role of endometriosis in cancer and tumor development. Ann. N. Y. Acad. Sci. 2002; 955:281–92CrossRef Google Scholar PubMed

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 Scholar PubMed

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 Scholar PubMed

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 Scholar PubMed

Gertig, D. M., Hunter, D. J., Cramer, D. W., et al.Prospective study of talc use and ovarian cancer. J. Natl Cancer Inst. 2000; 92:249–52CrossRef Google Scholar PubMed

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; 24:161–4CrossRef Google Scholar PubMed

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; 80:56–61CrossRef Google Scholar

Elktabbakh, G. H., Yadev, P. R. and Morgan, A.Clinical picture of women with early stage ovarian cancer. Gynecol. Oncol. 1999; 75:476–9CrossRef Google 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; 13:395–8CrossRef Google Scholar PubMed

Bast, R. C., Xu, F. J., Yu, Y. H., et al.CA125: the past and future. Int. J. Biol. Markers 1998; 13:179–87CrossRef Google 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 Scholar PubMed

Schwartz, P. E.Nongenetic screening of ovarian malignancies. Obstet. Gynecol. Clin. North Am. 2001; 28:637–51,ⅶCrossRef Google Scholar PubMed

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):356–78SCrossRef Google Scholar PubMed

Jacobs, I. J., Skates, S. J., Macdonald, N., et al.Screening for ovarian cancer: a pilot randomised controlled trial. Lancet 1999; 353:1207–10CrossRef Google Scholar PubMed

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; 105:1136–47CrossRef Google Scholar PubMed

Kim, J. H., Skates, S. J., Uede, T., et al.Osteopontin as a potential diagnostic biomarker for ovarian cancer. J. Am. Med. Assoc. 2002; 287:1671–9CrossRef Google Scholar PubMed

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; 12:86–91CrossRef Google Scholar PubMed

Bosetti, C., Negri, E., Trichopoulos, D., et al.Long-term effects of oral contraceptives on ovarian cancer risk. Int. J. Cancer 2002; 102:262–5CrossRef Google Scholar PubMed

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; 152:233–41CrossRef Google 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; 94:32–8CrossRef Google Scholar

Piver, M. S.Prophylactic oophorectomy: reducing the U. S. death rate from epithelial ovarian cancer. A continuing debate. Oncologist 1996; 1:326–30Google Scholar PubMed

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; 47:94–100CrossRef Google Scholar PubMed

Watson, N. R., Studd, J. W., Garnett, T., et al.Bone loss after hysterectomy with ovarian conservation. Obstet. Gynecol. 1995; 86:72–7CrossRef Google Scholar PubMed

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; 156:148–57CrossRef Google Scholar PubMed

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 Scholar PubMed

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; 94:128–34CrossRef Google Scholar PubMed

Pelucchi, C., Vecchia, C., Chatenoud, L., et al.Dietary fibres and ovarian cancer risk. Eur. J. Cancer 2001; 37:2235–9CrossRef Google Scholar PubMed

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 Scholar PubMed

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; 22:303–9CrossRef Google Scholar PubMed

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; 34:424–5CrossRef Google 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; 37:641–5CrossRef Google Scholar PubMed

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; 20:1260–68CrossRef Google Scholar PubMed

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>CrossRef Google Scholar PubMed

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; 339:424–8CrossRef Google Scholar PubMed

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; 345:235–40CrossRef Google Scholar PubMed

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; 18:2728–32CrossRef Google Scholar PubMed

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; 346:1616–22CrossRef Google Scholar PubMed

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; 20:2092–100CrossRef Google Scholar PubMed

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; 20:2520–29CrossRef Google Scholar PubMed

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; 7:325–32CrossRef Google Scholar PubMed

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; 10:189–99CrossRef Google Scholar PubMed

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; 86:212–19CrossRef Google Scholar PubMed

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): 231–41CrossRef Google Scholar

Book contents

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

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Keywords

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