Ovarian cancer occurs when cells in the ovaries develop mutations in their DNA that cause them to multiply uncontrollably. Although it is unclear what causes ovarian cancer, the risk increases with age, and many women are diagnosed after menopause around the ages of 55-64.
Learn about 12 risk factors for ovarian cancer and how you can reduce your chances of developing the disease.
12 risk factors for ovarian cancer
1. Family history
About 20%-25% of women diagnosed with ovarian cancer have a family history of the disease. An inherited genetic mutation in one of two genes, breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2), is the most important risk factor for ovarian cancer (BRCA2). These genes are thought to be responsible for 10%-15% of all ovarian cancers.
If you are a woman and your mother, sister, or daughter develops ovarian cancer, especially at a younger age, your risk of acquiring the condition increases. A woman who has a first-degree relative with ovarian cancer has a 5% lifetime risk.
Although it only accounts for a small percentage of cases, genetics is a significant risk factor for ovarian cancer. However, that doesn’t mean everyone with a family history develops ovarian cancer.
Other genes that increase the risk of hereditary ovarian cancer include ATM, BRIP1, RAD51C, RAD51D, and PALB2.
2. Personal history of cancer
If you have had breast cancer in the past, you may be at a high risk of ovarian cancer. Women with a family history of breast cancer are also more likely to develop ovarian cancer following breast cancer. A significant family history of breast cancer may result from an inherited mutation in BRCA1 or BRCA2 genes, as well as hereditary breast and ovarian cancer syndrome, which is associated with an elevated risk of ovarian cancer.
3. Lynch syndrome
Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, is a type of colorectal cancer that runs in families. Statistics have shown that up to 1 in every 300 people may be carriers of a gene mutation linked to Lynch syndrome. While Lynch syndrome is primarily known to raise the risk of colorectal cancer, it also accounts for a 12% increased lifetime risk of ovarian cancer.
4. Advancing age
The risk of ovarian cancer increases with age. Ovarian cancer is rare in women younger than 40 years, although it can affect women at any age. The majority of ovarian cancers are diagnosed after menopause, and about 50% are seen in women aged 63 years and older.
Obesity has been associated with an increased risk of a variety of cancers, although the exact link between obesity and ovarian cancer risk is unclear.
Women with a BMI of 30 or over are more likely to develop ovarian cancer and may have a worse prognosis than women at a healthy weight.
6. Nulliparity or late pregnancy
Nulliparous refers to women who have never given birth to a child. They have 24% higher risk of ovarian cancer than those who have given birth at least once. Women who had a full-term pregnancy after age 35 are also at an increased risk of ovarian cancer.
7. Early menstruation and late menopause
Ovarian cancer is estrogen-dependent. Experts suggest that women who start menstruation at an early age and reach menopause late have a higher risk of ovarian cancer. This is because they are exposed to estrogen for longer, which is the hormone that stimulates ovulation.
8. Hormonal replacement therapy (HRT)
Hormones function as chemical messengers and can have an effect on your growth, mood, and fertility. During menopause, the ovaries begin to produce less of estrogen, which can cause menopausal symptoms such as hot flashes and mood swings. HRT alters hormone levels in the body to alleviate these symptoms. Studies have shown that HRT can increase the risk of ovarian cancer.
The incidence of ovarian cancer is the highest in Caucasian women in Europe and North America and lowest in women of color in other countries. Ovarian cancer rates are low among Asian women, although this is probably due to environmental factors, since their risk increases when they come to Western countries and adopt new lifestyles and diets.
According to population studies, ovarian cancer rates are the highest in affluent areas where high-fat diets are more common. Animal fats in red meat and full-fat milk and cheese appear to have the closest link to ovarian cancer.
11. Genetic mutations
- Peutz-Jeghers syndrome: Peutz-Jeghers syndrome is caused by mutations in the STK11 gene. It is a rare genetic disease that causes polyps in the digestive tract and usually manifests among teenagers. Women with this syndrome have a high risk of ovarian cancer.
- MUTYH-associated polyposis: Caused by mutations in the MUTYH gene, this condition leads to the development of polyps in the colon and small intestine, which increases the risk of colon cancer. This can increase the risk of other malignancies, such as ovarian and bladder cancer.
12. Talcum powder
Use of talcum powder directly over the vaginal region or on sanitary napkins has been linked to ovarian cancer. However, some research suggests that these findings may be related to the fact that talcum powder was occasionally contaminated with asbestos, which is a known cancer-causing material.
What are the symptoms of ovarian cancer?
There are often no noticeable symptoms of ovarian cancer, especially during the early stages. However, you may experience one or more of the following:
- Abdominal bloating or discomfort
- Discomfort in the pelvic region or back
- Constipation or diarrhea
- Loss of appetite or early satiety
- Unintended weight loss
- Increased frequency or urgency to urinate
- Menstrual irregularity
- Pain during intercourse
If you experience these symptoms or you are at a risk of ovarian cancer or any other cancer, you should talk to your doctor.
How is ovarian cancer treated?
Ovarian cancer treatment is determined based on factors such as:
- Type and stage of the cancer
- Overall health
- Whether you want to have children
Treatment for ovarian cancer usually involves surgery and may include the removal of your ovaries, uterus, fallopian tubes, cervix, and a portion of your intestine or bladder.
If you are not a good candidate for surgery, your doctor may offer various therapies instead of surgery. These treatment modalities are often given even before or after surgery and may include:
Your doctor can discuss the advantages, risks, and side effects of each of these therapies in your specific case.
How to reduce the risk of ovarian cancer
- Birth control pills: Women who use oral contraceptives for at least 3 months are less prone to develop ovarian cancer. The risk reduces if the contraceptives are used for a longer period of time, even after the birth control pills are discontinued. The reason behind it is that oral contraceptives inhibit ovulation and lead to anovulatory cycles (cycles without eggs). As active multiplication of cells to form eggs in the ovary halts, the chances of ovarian cancer are lowered.
- Pregnancy and lactation: Women who have had at least one child, especially before the age of 30 years, have a lower risk of ovarian cancer. The reason for this is because pregnancy and lactation (breastfeeding) causes ovulation to stop, which is considered protective against ovarian cancer.
- Tubal ligation and hysterectomy: Having your tubes tied lowers your risk of ovarian cancer. Removing your uterus (hysterectomy) has also been associated with a lower risk of ovarian cancer, although recent studies have shown that this may be affected by factors such as your age at the time of the procedure.
- Smoking cessation: Smoking increases the risk of various r types of cancer, which in turn may increase the risk of ovarian cancer.
- Weight reduction and healthy eating habits: Obesity is a known risk factor for ovarian cancer. Maintaining a healthy weight through regular physical activity and a nutritious diet can help lower the risk of ovarian cancer. Reduce the intake of processed meats and high-fat foods and consume plenty of fresh fruits and vegetables.
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