According to the American Cancer Society, ovarian cancer is the fifth leading cause of cancer in women, accounting for more deaths than any other cancer of the female reproductive system. Impacting as many as 250,000 women each year, ovarian cancer is referred to as a silent disease because most women do not experience symptoms until its later stages. It is estimated that in 2022, about 19,880 new cases of ovarian cancer will be diagnosed. Ovarian cancer survival rates are much lower than other cancers that affect women. But when caught early and before the disease spreads, 90 percent of women can be cured.
Only about 20% of ovarian cancers are found at an early stage but when it is found early, about 94% of patients live longer than five years after diagnosis. Regular women’s health exams that include a complete pelvic exam can be useful in detecting some female cancers at an early stage, but most early ovarian tumors are difficult or impossible to feel. Screening tests used for cervical cancer, such as a Pap test or HPV (human papillomavirus) test aren’t effective tests for ovarian cancer.
There has been a lot of research to develop a screening test for ovarian cancer, but there hasn’t been much success so far. The two tests used most often, in addition to a complete pelvic exam, to screen for ovarian cancer are transvaginal ultrasound (TVUS) and the CA-125 blood test.
TVUS is a test that uses sound waves to look at the uterus, fallopian tubes, and ovaries. It can help find a mass (tumor) in the ovary, but it can’t tell if a mass is cancerous or benign. When it is used for screening, most of the masses found are not cancer.
The CA-125 blood test measures the amount of a protein called CA-125 in the blood. The problem with using the CA-125 blood test for ovarian cancer screening is that high levels of CA-125 are more often caused by common conditions such as endometriosis and pelvic inflammatory disease. Also, not everyone who has ovarian cancer has a high CA-125 level. When someone who is not known to have ovarian cancer has an abnormal CA-125 level, the doctor might repeat the test (to make sure the result is correct) and may consider ordering a transvaginal ultrasound test.
It is estimated that nearly 20 percent of ovarian cancers are caused by a genetic mutation. The genes most likely to increase the risk of ovarian cancer are BRCA1 and BRCA2. These genes also affect a woman’s risk of breast cancer. While these genetic mutations can increase risk, anyone with ovaries is at risk of ovarian cancer. However, some factors, such as family history, genetic predisposition, increasing age and use of hormone replacement therapy can put one at a higher risk.
For some, knowing family history and seeking out genetic testing is one way to detect risk for ovarian cancer early. Some organizations state that TVUS and CA-125 may be offered to screen women with a high risk of ovarian cancer due to an inherited genetic syndrome such as Lynch syndrome, BRCA gene mutations or a strong family history of breast and ovarian cancer. Still, even in these women, it has not been proven that using these tests for screening lowers their chances of dying from ovarian cancer.
Ovarian cancer is hard to detect in its early stages due to its vague symptoms. Women may experience constipation, bloating, early satiety after eating and back pain. Prompt attention to symptoms may improve the odds of early diagnosis and successful treatment.
While ovarian cancer tends to occur in post-menopausal women, anyone can be at risk. Several factors, including smoking, endometriosis, polycystic ovary disease, and obesity can raise a woman’s risk for ovarian cancer.
There is no known way to prevent ovarian cancer, but there are things associated with a lower chance of getting ovarian cancer. These include having used birth control pills for five or more years or having given birth. Women who have had a tubal ligation, both ovaries removed or a hysterectomy tend to lower their risk. Studies suggest that women who breastfeed for a year or more may have a modestly reduced risk of ovarian cancer.
Better ways to screen for ovarian cancer are being researched, but currently there are no reliable screening tests. Hopefully, improvements in screening tests will eventually lead to fewer deaths from ovarian cancer. If you notice any changes in your body that are not normal for you and could be a sign of ovarian cancer, talk to your doctor about them. If you or your family have a history of ovarian cancer, speak to your doctor about genetic counseling.
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