Risk Factors
Ovarian Cancer risk factors:
Several epidemiologic studies have suggested that exposure to endogenous and exogenous hormones play an important role in ovarian cancer etiology.
Some risk factors are reportedly associated with specific histotypes of ovarian cancer. It is also well established that endometriosis is risk factor for clear cell and endometrioid ovarian cancer, but not for high-grade serous or mucinous histotypes.
Decreased Risk
ORAL CONTRACEPTIVE
Ovarian cancer risk can be lowered if a woman has taken oral contraceptive during her reproductive life, with a lower risk occurring the longer the duration of use. Oral contraceptive use is associated with reduced risk for the serous and endometrioid subtypes, but is only weakly associate with reduced risks of mucinous and clear cell ovarian cancers.
BREAST FEEDING
Breastfeeding both at a younger age and over multiple offspring has been found to reduce the risk of ovarian cancer
PREGNANCY
Pregnancy and Parity are both protective, with decreased risk associated with increased parity.
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OTHER DECREASED RISK FACTORS
The removing of the uterus without removing the ovaries also seems to confer some reduction in risk in the development of OC.
Increased Risk
WEIGHT
Obesity may be weakly associated with an increased risk of low-grade serous invasive tumors but not invasive high-grade serous disease; and high body mass index may be associated with increased risk of borderline serous, invasive endometrioid, and invasive mucinous ovarian cancers. A BMI greater than 30 not only increases risk, but also negatively affects survival outcome.
AGE
An irregular pattern of menstruation throughout a woman’s life (frequent menstrual bleeding less than 21 or more that 35 days apart) was negatively associated with the risk of ovarian cancer. Furthermore, starting one’s period before the age of 12 or completing menopause after the age of 55 seems to be associated ovarian cancer risk factors.
SMOKING
There is an association between smoking and mucinous ovarian cancer, an inverse association for risks of endometrioid and clear cell ovarian cancers, and no association with high-grade and borderline serous histotypes.
GENETIC MUTATION
BRCA1 and BRCA2 gene mutations are responsible for most inherited ovarian cancers, with a cancer risk between 35% and 70% in BRCA1 patients and between 10% and 30% in BRCA2. In comparison, the general population OC risk without these mutations is less than 2%. Other genes associated with hereditary OC include BRIP1, RAD51C, PALB2, and ATM.
FAMILY HISTORY
Family history of disease must also be considered when assessing risk. Ovarian cancer risk increases the more relatives you have diagnosed with the disease. Colorectal and breast cancer in close family members can also be associated with increased risk.
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OTHER INCREASED RISK FACTORS
Although initially thought to be a benign disease, today ovarian endometrioses are classified as neoplastic conditions that may have the potential to lead to cancer. This increased risk of developing epithelial ovarian cancer falls mainly into two distinct subtypes: clear cell and endometrioid.
Women who use hormone therapeutics after menopause, such as estrogens or progesterone treatments, have an increased risk of OC diagnoses when compared with women who have never used hormone replacements.
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