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Risk Factors Genetics and Screening

Ovarian, Fallopian or Primary Peritoneal Cancer Risk Factors

There is no specific risk factor associated with all forms of ovarian cancer. There has been some research, however, that has revealed there are some factors that seem to increase the chances for developing epithelial ovarian cancer. The following risk factors apply to epithelial ovarian cancer as well as fallopian and primary peritoneal cancer:

    Age: the average age of women diagnosed with ovarian, fallopian or primary peritoneal cancer is 60 years.

    A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers. But having a risk factor, or even several, does not mean that you will get the disease.

    Obesity / Diet: Overweight women are more likely to develop ovarian, fallopian and/or primary peritoneal cancer and some studies have suggested women whose diets don’t include enough fruits and vegetables are also at an increased risk.

    Family History: Women whose mother, sister, aunt and/or grandmother (on either side of the family) have had ovarian cancer are at a higher risk of also developing ovarian cancer. They are also at an increased risk for fallopian or primary peritoneal cancer.

    Personal history of breast, uterine or colorectal cancer: Research has shown that women who have had one of these cancer is more likely to develop ovarian cancer.

    Estrogen / Other Hormone Therapy: Women taking estrogen without progesterone appear to be at a slightly higher risk for ovarian cancer than women taking both estrogen and progesterone.

    Endometriosis: this condition, where tissue from the lining of the uterus grows to other parts of the body, has been connected to an increased risk of ovarian, fallopian and primary peritoneal cancer.

    Talcum powder: There has been some research proving a slight increased risk for ovarian cancer for women who use talcum powder. There is no evidence linking cornstarch powders with any female cancers.

A small number of ovarian cancers are hereditary.

While many women are diagnosed with gynecologic cancers each year, only a small percentage -- usually those diagnosed with ovarian cancer -- are caused by an inherited genetic mutation. Some of these women may have already been diagnosed with breast cancer, since the same genetic mutation that causes 5-10% of breast cancers also puts a woman at higher risk of ovarian cancer. Genetic counseling for these genes - known as BRCA1 and BRCA2 mutations - can tell a woman whether she is at increased risk for these cancers. Mutations in BRCA1 and BRCA2 account for approximately 80-90% of all hereditary breast cancers, and women who carry mutations in these genes have a lifetime risk of breast cancer that is roughly 10 times greater than that of the general population. The test does not guarantee who will or will not get breast cancer or ovarian cancer.

Those most appropriate for genetic counseling have:

  • A personal history of ovarian, fallopian tube or primary peritoneal cancer
  • High numbers of family members with cancer diagnoses (especially breast and ovarian) throughout several generations, either maternal or paternal
  • Family member diagnosed with cancer before age 50
  • Family members who have been diagnosed with multiple cancers (for example, breast and ovarian)
  • Male breast cancers, or clusterings of other cancers such as colon, prostate, stomach or pancreatic

While it's important for every woman to understand her individual risk, genetic testing may not be the right option for everyone. The Breast and Ovarian Risk Evaluation Program, led by Dr. Sofia Merajver, provides individuals with an accurate assessment of their personal risk for developing breast cancer or ovarian cancer and offers a plan for follow-up and preventive care.

Symptoms

Some women have reported the following symptoms:

  • Vaginal bleeding (particularly if you are past menopause), or unusual discharge.
  • Pain or pressure in the pelvic area.
  • Abdominal or back pain.
  • Bloating.
  • Feeling full too quickly, or difficulty eating.
  • A change in your bathroom habits, such as more frequent or urgent need to urinate and/or constipation.

Screening

There is no standard or routine screening test for any gynecologic cancers, other than cervical cancer.

The following tests can help identify a potential problem:

    The pelvic exam: when a physician feels the size, shape and position of the uterus and ovaries.

    Transvaginal ultrasound (TVU) examines the vagina, uterus, fallopian tubes, and bladder by inserting an ultrasound transducer (probe) into the vagina. The probe bounces high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

    CA-125 is a test that measures the level of CA 125 in the blood. CA 125 is a substance released by cells into the bloodstream. An increased CA-125 level is sometimes a sign of certain types of cancer, including ovarian cancer, or other conditions.

For more information on the causes, risk factors, symptoms, diagnosis, prevention, and treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, visit the following sites: