Ovarian cancer affects less than 2% of people with ovaries, but it leads to more deaths than any other gynecologic cancer. One reason is that 80% of ovarian cancers are not detected until later stages — when the disease can be more challenging to treat. The signs of early stage disease can be subtle or mimic other common conditions, and there is currently no cancer screening available for ovarian cancer for those with no existing signs or symptoms.
Until regular screening becomes available, the best way to protect yourself against ovarian cancer is to understand your risk and know how to recognize the early signs.
Determining your risk for ovarian cancer
Most ovarian cancer is the result of genetic changes that naturally happen over time, often as a result of lifestyle choices or personal health history. Risk factors for ovarian cancer include:
- Age, with half of ovarian cancer diagnoses in people 63 and older
- Body weight, with a body mass index (BMI) of 30 or more increasing the risk
- Height, with tall women at greater risk
- Hormone replacement therapy taken after menopause
- Personal health history that includes breast cancer, endometriosis or pelvic inflammatory disease
- Reproductive history if you’ve never been pregnant or had your first child after age 35
The Centers for Disease Control and Prevention (CDC) reports that you may be able to lower your risk of ovarian cancer if you use birth control pills containing estrogen and progesterone for at least five years. Breastfeeding for more than a year may also reduce the risk.
Approximately 20% of people who develop ovarian cancer have been at high risk since birth because of an inherited gene mutation. According to the American Cancer Society, the most common hereditary cancer syndromes related to ovarian cancer include:
- Hereditary breast and ovarian cancer (HBOC) syndrome, which is caused by mutations in the BRCA1 and BRCA2 genes
- Lynch syndrome, which can involve multiple gene mutations that increase the risk of ovarian cancer
- Hereditary non-polyposis colorectal cancer (HNPCC), which can have gene mutations also associated with ovarian cancer
- Peutz-Jeghers syndrome, which increases the risk of gynecological cancers
- MUTYH-associated polyposis, caused by mutations in the MUTYH gene
Knowing your family health history is a critical factor in determining your risk for ovarian cancer. If a first-degree relative — such as a mother, aunt, grandmother or sister — had ovarian cancer or you have a family history of an associated hereditary condition, you may be a candidate for genetic testing. Testing can identify hereditary syndromes and genetic mutations known to cause ovarian cancer. Genetic counselors can provide information about options for preventing ovarian cancer if your risk is high.
Recognizing the early signs of ovarian cancer
The early stages of ovarian cancer do not always produce symptoms. When there are signs of ovarian cancer, they can be subtle or assumed to be related to other conditions.
Symptoms associated with early stage ovarian cancer may include:
- Abdominal or back pain
- Bloating or abdominal distention (swelling)
- Changes in bathroom habits including increased urgency or frequency
- Feeling full quickly or having trouble eating
- Pain or pressure in the pelvic area
- Vaginal bleeding, especially if you are post-menopausal
If you have unusual vaginal bleeding, see a physician immediately. For all other signs, consult a physician if the symptoms are a significant change from the norm or are persistent. Detecting ovarian cancer early offers the best chance of effective treatment.
Screening and ovarian cancer
Unlike cervical cancer — which may be detected through a human papillomavirus (HPV) test or Pap smear — there is currently no screening protocol for ovarian cancer.
However, cancer researchers are working to find new ways to screen for ovarian cancer. One potential screening method involves looking at the pattern of proteins in your blood to detect ovarian cancer, but more testing is needed.
Until reliable ovarian cancer screening is available, it’s critical to identify your risk and report any possible symptoms to your physician.
