Risk Factors – Ovarian Cancer 101
Risk Factors 2018-03-02T20:57:09+00:00

While most women with ovarian cancer do not have any known risk factors, some do exist. If a woman has one or more risk factors, she will not necessarily develop ovarian cancer; however, her risk may be higher than the average woman’s.

Genetics
• About 10 to 15 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. The most significant risk factor for ovarian cancer is an inherited genetic mutation in one of two genes: breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2). These genes are responsible for about 5 to 10 percent of all ovarian cancers.
• Eastern European women and women of Ashkenazi Jewish descent are at a higher risk of carrying BRCA1 and BRCA2 mutations.
• Since these genes are linked to both breast and ovarian cancer, women who have had breast cancer have an increased risk of ovarian cancer.
• Another known genetic link to ovarian cancer is an inherited syndrome called hereditary nonpolyposis colorectal cancer (HNPCC or Lynch Syndrome). While HNPCC poses the greatest risk of colon cancer, women with HNPCC have about a 12 percent lifetime risk of developing ovarian cancer.
• Women who have one first-degree relative with ovarian cancer but no known genetic mutation still have an increased risk of developing ovarian cancer. The lifetime risk of a woman who has a first degree relative with ovarian cancer is five percent (the average woman’s lifetime risk is 1.4 percent).

Increasing Age
•All women are at risk of developing ovarian cancer regardless of age; however, a woman’s risk is highest during her 60s and increases with age through her late 70s. About 69 percent of women diagnosed with ovarian cancer in the United States from 2002 to 2006 were 55 or older. The median age (at which half of all reported cases are older and half are younger) at diagnosis is 63.

Reproductive History and Infertility
• Research suggests a relationship between the number of menstrual cycles in a woman’s lifetime and her risk of developing ovarian cancer. A woman is at an increased risk if she:
started menstruating at an early age (before 12),
has not given birth to any children,
had her first child after 30,
experienced menopause after 50,
has never taken oral contraceptives.
has experienced infertility, regardless of whether or not a woman uses fertility drugs, also increases the risk of ovarian cancer.

Hormone Replacement Therapy
• Doctors may prescribe hormone replacement therapy to alleviate symptoms associated with menopause (hot flashes, night sweats, sleeplessness, vaginal dryness) that occur as the body adjusts to decreased levels of estrogen. Hormone replacement therapy usually involves treatment with either estrogen alone (for women who have had a hysterectomy) or a combination of estrogen with progesterone or progestin (for women who have not had a hysterectomy).
• Women who use menopausal hormone therapy are at an increased risk for ovarian cancer. Recent studies indicate that using a combination of estrogen and progestin for five or more years significantly increases the risk of ovarian cancer in women who have not had a hysterectomy. Ten or more years of estrogen use increases the risk of ovarian cancer in women who have had a hysterectomy.

Obesity
Various studies have found a link between obesity and ovarian cancer. A 2009 study found that obesity was associated with an almost 80 percent higher risk of ovarian cancer in women 50 to 71 who had not taken hormones after menopause.

Reducing Risk
Women can reduce the risk of developing ovarian cancer in many ways; however, there is no prevention method for the disease. All women are at risk because ovarian cancer does not strike only one ethnic or age group. A healthcare professional can help a woman identify ways to reduce her risk as well as decide if consultation with a genetic counselor is appropriate.

Oral Contraceptives (birth control pills)
The use of oral contraceptives decreases the risk of developing ovarian cancer, especially when used for several years. Women who use oral contraceptives for five or more years have about a 50 percent lower risk of developing ovarian cancer than women who have never used oral contraceptives.

Certain people in the LGBT community are at increased risk for ovarian cancer.
Lesbian women are less likely to benefit from known risk reducing factors such as taking oral contraceptives, childbirth and breast feeding. The theory is that the less a woman ovulates, the lower her risk of being diagnosed with ovarian cancer.

Another ovarian cancer risk is being overweight, with nearly three-quarters of adult lesbians overweight or obese.

Female to Males should be especially aware of the symptoms of ovarian cancer as they too are at risk.  Taking testosterone may increase the risk of ovarian cancer. However, ovarian cancer is sensitive to estrogen, and there is evidence that in FTMs some testosterone is converted to estrogen. (This is especially significant for those people obtaining hormones from unlicensed sources, not from a medical provider.)

If there has been a hysterectomy, it is important to note a simple hysterectomy removes your cervix and uterus but leaves your ovaries and fallopian tubes intact. So you can still develop ovarian cancer. Another type of hysterectomy called a total hysterectomy with salpingo-oophorectomy removes your cervix and uterus as well as both ovaries and fallopian tubes.

Removing the ovaries dramatically reduces your risk of ovarian cancer by more than 95 percent. But you still have a small risk of primary peritoneal cancer, which acts just like ovarian cancer and is treated similarly.

Finally, for a variety of reasons – among them, too many LBGT people don’t have health insurance and often skip “healthy” checkups. According to the Mautner Project, a LGBT health advocacy group, “Because lesbians do not usually need contraceptives, they tend to wait longer between Pap smears and general gynecological exams.” Those “general gynecological exams” are an essential part of diagnosing ovarian cancer and due to discomfort with revealing transgenderism, many transsexuals don’t get the exams that they need.

In addition to the risk factors discussed above, a family history of ovarian, uterine or breast cancer or testing positive for the BRCA1 or 2 genes increase risk.

There is no screening test for ovarian cancer (a pap test does NOT detect it). At the very least, it’s crucial for every person with ovaries – including lesbians, bisexual women, and transgender men who have not had their ovaries removed – to have a comprehensive gynecological pelvic exam each year.

The annual gynecological exam should include both the speculum exam and the bimanual exam (which is having your medical provider actually feel your ovaries and uterus for abnormalities.

Knowing the symptoms is critical to early detection of the disease.

  • Bloating
  • Eating little and feeling full quickly
  • Abdominal/Pelvic Pain
  • Changes in bathroom habits

 

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