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Ovarian cancer is not very common, affecting less than 2 percent of women in the United States. Every year, approximately 21,880 cases are diagnosed. When ovarian cancer occurs, it is often fatal, having a higher mortality rate than uterine, cervical and any other gynecological cancer.
There are 13,850 deaths attributable to ovarian cancer each year. The five-year survival rate is less than 45 percent.
Like many cancers, ovarian cancer is most often curable when it is detected early — at stage one or two. Stage one means the cancer is confined to the ovaries. In stage two, the cancer has extended into the pelvis. The outcome is less positive in stages three and four, when the cancer has spread beyond the pelvis. The main reason ovarian cancer is so deadly is that it rarely is detected before reaching stage three or four.
Who develops ovarian cancer?
It’s hard to predict who may develop ovarian cancer.
We know the incidence of ovarian cancer increases with age. The highest proportion of cases occurs in women 50 to 59 years old. The risk increases in women with a close relative who has had ovarian cancer, women who are infertile and women who have never been pregnant. The risk is lower in women who have used oral contraceptives, had a tubal ligation, had at least one pregnancy or breastfed.
Women who have a strong family history of breast and/or ovarian cancer sometimes seek genetic testing and learn they have inherited the genetic mutations BRCA1 or BRCA2. A woman who has the BRCA1 mutation has a 35 to 45 percent risk of developing ovarian cancer. Those with a BRCA2 mutation have a 15 to 25 percent risk. Women who have these mutations may want to talk with their doctors about considering surgical removal of the ovaries, especially after they have completed child-bearing. However, most women who develop ovarian cancer do not have these genetic mutations.
How ovarian cancer is detected
Bloating and a feeling of pressure in the abdomen are the symptoms of ovarian cancer. These symptoms, however, can also be caused by many other conditions. Diagnosing ovarian cancer is not easy. It is not detected by a Pap smear or a uterine biopsy.
A blood test called CA 125 has been touted as a screening tool for ovarian cancer. This test often produces false positive results caused by endometriosis, infection, cysts, pregnancy and a number of other factors. A positive test result may mean that a woman goes through the physical and psychological stress of surgery when she does not need it.
Studies have shown that survival rates are no better in ovarian cancer patients who have a positive CA 125 test than in those who do not have the test at all. For this reason, no medical organization supports routine screening using the CA 125.
Sonograms and pelvic examinations can sometimes detect an ovarian abnormality, but may also produce ambiguous results.
What can I do?
Researchers are still working on better diagnostic tests for ovarian cancer, but for now there is no simple answer. Women who are of childbearing age and older should see their doctor regularly to discuss risk factors and symptoms of any kind.
