Many risk factors have been associated with an increased prevalence of ovarian cancer. Risks include a personal history of disease, family history, genetics, age, and reproductive factors.
Parity is another risk factor as nulliparous women have an increased risk of being diagnosed with ovarian cancer (2). Conversely, women who have given birth have a lower chance of developing ovarian cancer; in general, the lifetime risk of developing ovarian cancer decreases with each live birth (2). Lastly, nutrition plays a role, as a diet high in saturated fat and meat is associated with an increased risk of ovarian cancer. Factors associated with a decrease in risk include higher parity, use of oral contraception, and gynecologic procedures such as hysterectomy and tubal ligation (4). In fact, oral contraceptive use is one of the most significant methods for decreasing the risk of ovarian cancer.
The most important risk factor is a family history of breast or ovarian cancer. Women who have had breast cancer are at greater risk of developing ovarian cancer. The risk of ovarian cancer after breast cancer is highest in women who have a family history of breast cancer. In contrast to the 1.8% general population at risk for ovarian cancer, a family history of ovarian cancer in a first-degree relative (mother, daughter, sister) triples a woman’s lifetime risk of developing ovarian cancer (2). The risks further increase with two or more afflicted first-degree relatives (~7%). Up to 10% of ovarian cancers result from an inherited tendency to develop the disease. While 90% of diagnosed epithelial ovarian cancers occur sporadically, 10% are associated with the inheritance of an autosomal dominant genetic aberration (3). Women who have inherited high-penetrance cancer susceptibility genes, such as mutated BRCA1 or BRCA2 genes or those constituents of Lynch syndrome (hereditary nonpolyposis colorectal cancer, HNPCC), are at a greatly increased risk of developing ovarian cancer. Women who have had breast cancer are at greater risk of developing ovarian cancer. Women who have inherited high-penetrance cancer susceptibility genes, such as mutated BRCA1 or BRCA2 genes are at a greatly increased risk of developing ovarian cancer. A woman with BRCA1 mutation has a lifetime risk of 39% to 70 % of developing ovarian cancer and a risk of 11 to 25% for BRCA2 carriers (1). The NIH consensus statement concluded that women at increased risk should have at least an annual comprehensive gynecological examination (pelvic and rectovaginal), serum marker CA125, and transvaginal/abdominal ultrasound, despite the lack of data supporting the use of these measures for ovarian cancer screening (5). To reduce the morbidity and mortality from ovarian cancer one must identify early rather than advanced stage disease.
(1) Rock JA, Jones III HW. TeLinde’s operative gynecology. 10th ed. 2008. Philidephia, Pa. Lippincott Williams & Wilkins. Pp 1307-1312
(2) Schorge JO, Modesitt SC, Coleman RL, Cohn DE, Kauff ND, Duska LR, Herzog TJ. SGO White Paper on ovarian cancer: etiology, screening and surveillance. Gynecol Oncol. 2010; 119(1) 7-17
(3) Clarke-Pearson DL. Screening for ovarian cancer. N Engl J Med. 2009l 361(2): 170-177
(4) Rein BJD, Gupta S, Dada R, Safi J, Michener C, Argawal A. (Review Article) Potential markers for detection and monitoring of ovarian cancer. Journal of oncology. Vol 2011
(5) Ovarian Cancer: Screening, Treatment, and Followup. NIH Consensus Statement 1994 April 5-7;12(3):30
Top Answer by: DavidFishmanMD
(Physician - Oncology - Hematology/Oncology (Verified)