Ovarian cancer can develop in women with no obvious warning, so it is important to know what the risk factors are. Some genetic abnormalities, family history, age, reproductive history and medical conditions can increase risk, which helps identify women who may need closer medical attention.
Age and menopause
One of the strongest risk factors is age. Ovarian cancer is more common after menopause, especially among women over 50. The risk usually increases with age because genetic changes can accumulate in cells over time. But ovarian cancer can also occur in younger women, especially when inherited genetic changes are involved.
Family history and inherited genes
Women who have a family history of ovarian, breast, fallopian tube and other related cancers may be at increased risk. One of the known genetic risk factors is inherited changes in genes such as BRCA1 and BRCA2. Other inherited conditions such as Lynch syndrome can also increase the chance of ovarian cancer. Genetic counselling and testing may be considered if there is a family history of inherited risk.
Reproductive and hormonal factors
The risk of ovarian cancer may be affected by the number of times a woman ovulates during her lifetime. A longer period of ovulation, indicated by starting periods early, going through menopause late, having fewer pregnancies, and never being pregnant, has been associated with an increased risk. Pregnancy and breastfeeding reduce the number of ovulations over a woman's lifetime and may offer some protection. Combined oral contraceptive pills have also been linked to a lower risk of ovarian cancer, but they are not for everyone and should not be used solely for cancer prevention.
Endometriosis and certain medical conditions
Endometriosis may increase the risk of developing some types of ovarian cancer, particularly endometrioid and clear cell tumors. But most women with endometriosis will not develop ovarian cancer. Other inherited conditions can also increase risk because they affect the body’s ability to repair DNA damage. Women with a personal history of breast or colorectal cancer may have increased risk as well. These factors should be discussed with a doctor for appropriate risk assessment and genetic counselling as indicated.
Obesity and lifestyle factors
Higher body weight and obesity have been linked to an increased risk of ovarian cancer, but the strength of the association may vary by cancer type. Physical activity, a healthy weight and a well-rounded diet are all good for your general health and may help reduce a number of cancer-related risks. Smoking is also associated with some forms of ovarian cancer, particularly mucinous ovarian tumours.
Hormone therapy after menopause
A slightly increased risk of ovarian cancer has been associated with long-term use of menopausal hormone therapy, especially estrogen-only therapy. Decisions about hormone therapy should be made based on individual symptoms, age, medical history and personal risk factors, not just cancer risk.
What women with higher risk should know
If you have a strong family history of ovarian cancer or a known genetic risk, talk to a gynaecologist or genetic counsellor about your personal risk. Based on your personal factors, your doctor may talk to you about genetic testing, closer monitoring and prevention options. Avoiding tobacco and early reporting of persistent symptoms are also important. Keeping a healthy weight is important too. Any new and persistent symptoms such as bloating, pelvic and abdominal pain, early satiety, or changes in urinary as well as bowel habits should be evaluated, particularly if they are atypical for the individual or occur frequently.
The author is the chairperson of Radiation Oncology at Medanta Hospital, Gurugram.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
