#GCAM Ovarian Cancer Risk Factors

Since there is no screening test for ovarian cancer understanding your risk for the disease is important. 

Family history is a strong risk factor for being diagnosed with ovarian cancer. 

Does your family - mother, sibling or daughter have ovarian cancer?  According to the American Cancer Society your risk is 4 times the general population. If your mother, sister or daughter has been diagnosed with breast cancer your risk is increased by 70%. This increased risk is due to mutations in the BRCA1 and BRCA2 genes. If you are of Ashkenazi Jewish ancestry you have a 1 in 40 chance of having a BRCA1 mutation placing you at risk for ovarian cancer and breast cancer. There are a number of online resources that can help you have that conversation with relatives about family history. The CDC has an app My Family Health Portrait: Cancer app you can use to collect family history.

Other risk factors for ovarian cancer include:

Lynch Syndrome ( 12% lifetime risk of ovarian cancer)  

Your history of other cancers( breast, uterine, colorectal) 

Your history of endometriosis ( Associated with Low-grade serous carcinoma, Clear cell carcinoma, Mucinous carcinoma, Endometrioid carcinoma)

Age ( the median age of diagnosis is 63)

Early menstruation, no childbirth,  child birth after 30 , no oral contraceptive use  and infertility 

Obesity

  

We may not be able to prevent cancer but there are ways to reduce your risk of ovarian cancer? 

If you use oral contraceptives for five years you can reduce your risk by 50%. Multiple pregnancies ( ovulating less)  and pregnancy before 26 years old can also reduce your risk. 

Another way to reduce risk is to have your Fallopian tubes removed. Many High grade serous ovarian cancers originates in the Fallopian tubes.  The surgery to remove the Fallopian tubes when done during another gynecologic surgery such as a hysterectomy is called opportunistic salpinectomy. This surgery leaves the ovaries intact. 

For women with a BRCA1 or 2 genetic mutations risk can be reduced by having a  bilateral  salpingo-oopherectomy where the fallopian tubes and ovaries are removed surgically. Primary peritoneal cancer may still occur after this surgery but it is rare. 

Sources : https://ocrahope.org/for-patients/prevention-risk/ , https://www.cancer.org , https://www.basser.org/brca/brca-ashkenazi-jewish-community

 In my next post I'll talk about diagnosis and types of ovarian cancer. 

 Dee

Every Day is a Blessing! 

Day 5: A Month of Teal - Ovarian Cancer Risk Factors

1 in 75 women develop ovarian cancer 

Risk factors for epithelial ovarian cancer ( the most common type) include: 

• Increased Age 
• Genetics :  BRCA 1 or 2 Mutation, Lynch Syndrome, Peutz-Jeghers syndrome, Nevoid basal cell carcinoma syndrome, Li-Fraumeni and Ataxia-Telangiectasia (http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/risk-factors-and-prevention )
• A family history of epithelial ovarian cancer, fallopian tube cancer, peritoneal cancer, premenopausal breast cancer and/or male breast cancer
• Endometriosis
• Being of Ashkenazi Jewish heritage
• Being post menopausal
• Infertility, never having children
• Obesity
• Using menopausal hormone therapy

For more information please see:
https://ocrfa.org/patients/about-ovarian-cancer/risk-factors/ 
http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/risk-factors-and-prevention


Dee
Every Day is a Blessing! 

Of SGO and AACR

SGO

The Society of Gynecologic Oncologist held its annual meeting in Tampa in March. There were a number of studies whose results were presented that are of interest to ovarian cancer patients. The SGO also issued a clinical practice statement recommending genetic testing for all women diagnosed with ovarian cancer and endometrial cancers. The #gyncsm(gyn cancer social media)  chat ( of which I am co-moderator) discussed SGO News during their April 9th Chat. To see the topic questions, read the transcript of the chat or refer to the resources presented during the chat,  please see their blog page. If you want to read through the abstracts from the meeting please visit https://www.sgo.org/wp-content/uploads/2014/03/ABSUPP_3.14.14.pdf

This Foundation for Women's Cancer video shares news from the meeting.

AACR

The American Association for Cancer Research  held their annual meeting early this month in California. While this annual meeting presented research for all cancers there were a number of interesting studies related to ovarian cancer. ( Search abstracts here.) A prospective study of of over 14,000 women in the Child Health and Development study found an association between irregular menstrual periods and the diagnosis of serous ovarian cancer . In  Irregular Menstruation May Predict Increased Risk of Death From Ovarian Cancer.  published online by AACR, 

“It is notable that the 2.4-fold increase in risk of ovarian cancer death we observed for women with irregular/infrequent cycles in this study is close to the threefold increase in risk observed for women with a family history of ovarian cancer in a first-degree relative,” explained Cohn. “Our study finding could lead to better understanding of the 90 percent of ovarian cancers that occur in women with no family history of ovarian cancer and with no known high-risk inherited mutations.”

The results were independent of race, age or weight. I know that my menstruation was very irregular when I was young and again about 5 years prior to my diagnosis. 

It may be too soon but I wonder if irregular menses needs to be added to our discussion of symptoms of ovarian cancer.   

Dee

Every Day is a Blessing!

Research News : Aspirin and Oophorectomies

ASPIRIN

Feb 6,2014 Journal of the National Cancer Institute

Chronic inflammation has been shown to increase the risk for cancer.Aspirin is known to possess  anti-inflammatory properties. Using data from 12 large epidemiological studies (8000 women with ovarian cancer and 12,000 without the disease) researchers at the NIH studied whether aspirin, non-aspirin NSAIDs (non-steroidal anti-inflammatory drugs) or acetaminophen had a lower risk of ovarian cancer.

Conclusion:  Daily use of low-dose aspirin was found to reduce the risk of ovarian cancer by 20-34% depending on the dose and frequency. The same low dose aspirin regime has show Cardiovascular  benefits.

My Take: Further prospective randomized studies are needed to verify this research.
There are risks to taking aspirin such as gastrointestinal bleeding but this may be a readily available low cost was to reduce a women's risk for ovarian cancer. .


OOPHORECTOMY 
Feb 24 Journal of Clinical Oncology

This study included over 5000 women with BRCA1 & 2  mutations who had their ovaries removed. The goal of the research was to estimate the reduction in the risk of developing ovarian, fallopian and peritoneal cancers by the age the women had their ovaries removed.The study also looked at the impact the surgery had on the women's mortality. 

Conclusion: Preventative oophorectomy in women with BRCA1 mutations reduces the risk of ovarian cancer by 80%. The study also found a 77% reduction in deaths by any cause by the age of 70 when women had the surgery. 

Recommendation: Women with BRCA1 mutation should  have their ovaries removed by age 35.  Waiting to a later age for the surgery increases the risk of being diagnosed with ovarian cancer. 

My Take: This study verified the importance of ovary removal at age 35 for women who carry the  BRCA1. Having to deal with menopause at an early age is not easy but women who are BRCA1 should discuss this surgery with their doctors . 


Notes:  Risk is the chance a person has of developing cancer over their lifetime. The risk of a woman developing ovarian cancer is 1.37 or 1 in 73 women. Data from ACS.


Dee
Every Day is a Blessing!

Endometriosis and Ovarian Cancer

A study published in The Lancet Oncology on February 22, 2012 (Association between endometriosis and risk of histoligical subtypes of ovarian cancer:pooled analysis of case-control studies ) showed that women with endometriosis had a significantly increase risk of low grade serous, endometrioid and clear-cell ovarian cancers. Researchers reviewed data from over 23000 women in 13 different studies who reported endometriosis. Other subtypes ( high grade, mucinous etc ) did not show the association. The study did not show a cause-and-effect relationship. The study recommends future research to understand how endometriosis is transformed into a malignant condition.

Additional information may be found here.

Dee

Every Day is a blessing!

A Protein and the Pill

These reports are too interesting to just post on my Latest OC Research Page.

All About a Protein:

This News Medical article titled " Fat Cells Play a Major Role in Mediating Ovarian Cancer Metastisis" explains in layman's terms how FABP4, a fatty acid binding protein, may promote the spread of ovarian cancer cells to the oomentum.

Here is a link to the original research in Nature Medicine "Adipocytes Promote Ovarian Cancer metastasis and Provide Energy for Rapid Tumor Growth"

The Pill and Risk:

An article "Oral Contraceptive Use and Reproductive factors and Risk of Ovarian Cacner in the European Prospective Investigation into Cancer and Nutrition" in the British Journal of Cancer showed that taking oral contraceptives for 10 years reduced a women's risk of getting Ovarian Cancer.

Here is a link to the News Medical article on the study.

Dee

Every Day is a Blessing!