COLLEGE OF PUBLIC HEALTH AND HUMAN SCIENCES
Risks For & Prevention Of Ovarian Cancer
Robinson, Tasha
What is Ovarian Cancer?
Ovarian cancer is a chronic, noncommunicable disease in
which, malignant cells are found within or closely external
to the ovaries (National Ovarian Cancer Coalition [NOCC],
2020).
Who Does It Effect?
Ovarian cancer is the second most common gynecologic
cancer in the United States (Centers for Disease Control
and Prevention [CDC], 2019). Ovarian cancer causes more
deaths than any other cancer of the female reproductive
system. In women ages 35-74, ovarian cancer is the fifth
leading cause of cancer-related deaths (NOCC, 2020). 1 in
78 women will develop ovarian cancer in their lifetime.
Symptoms
Symptoms of ovarian cancer include (American Cancer
Society, 2018a):
• Bloating
• Pelvic or abdominal pain
• Difficulties eating
• Urinary symptoms like urgency and frequency
• Fatigue
• Upset stomach
• Back pain
• Dyspareunia (pain during sex)
• Constipation
• Menstrual variability
• Abdominal swelling accompanied by weight loss
Etiology
We don’t yet know exactly what causes ovarian cancer
(American Cancer Society, 2018b) but we do know what
can increase or decrease the potential for developing
ovarian cancer. One of the main, un-modifiable risk factors
is one’s genetics. A family history of ovarian cancer, or
exposure to radiation that leads to gene mutation can lead
to an increased risk of ovarian cancer.
Associated Complications
Complications associated with the development of ovarian
cancer include discomfort, pelvic and abdominal pain,
urinary disorders, and death within 15 years of diagnosis
(Dinkelspiel et al., 2015). For women with ovarian cancer in
end of life care, complication included fatigue and
weakness, nausea or vomiting, constipation, extremity-
based edema, anemia, ascites, bowel obstruction, pleural
effusion, bladder obstruction, and disorders of nutrition
(Herrinton et al., 2007).
Risk Factor | Body Weight
Overweight and obesity are defined as abnormal or
excessive fat accumulation that presents a risk to health. A
person with a BMI of 30 or more is generally considered
obese. (World Health Organization, n.d.)
• Eleven studies contributed to analyses of BMI in early
adulthood and observed significantly increased risks of
both invasive and borderline ovarian cancers associated
with higher BMI (Olsen et al., 2018).
• A body mass index within the normal range is
associated with a lower risk of developing ovarian
cancer. When obese from the age of 18 compared to
those at a normal weight at the age of 18, the risk of
ovarian cancer increases in the long run (Leitzmann et
al., 2009).
• Obesity increase the risk of cancer by disrupting
hormone regulation in the body (Cancer Research UK,
2019). Excess adipose tissue produces excess growth
hormone in the body which can cause inflammation and
disrupt the adequate production of sex hormones,
leading to cell malformation in the ovaries.
• The most protective measure against developing ovarian
cancer when considering one’s body mass index is to
maintain a health body weight and fat distribution,
paired with moderate physical activity levels and a
diverse and healthy diet.
Obesity and Ovarian Cancer
Depicted above is the process by which excess fat cells can increase the risk for cell
disfunction and malformation. Retrieved from https://www.cancerresearchuk.org/about-
cancer/causes-of-cancer/obesity-weight-and-cancer/does-obesity-cause-cancer#Obesity0
Risk Factor | Endometrial Disruption Evidence-Based Intervention
Endometriosis and Ovarian Cancer
Depicted above is the process by which endometriosis and the abnormal endometrial cells
leads to the development of ovarian cancer. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0009898119300683
Endometriosis, the presence of endometrial tissue
external to the uterine cavity, is a condition that,
despite being relatively common, has the potential to
cause harm to patient’s health (Office on Women's
Health, 2019).
• Endometriosis is associated with an increased risk
v cardiovascular disease, and increased overall
of developing epithelial ovarian cancer (EOC)
(Brilhante et al., 2017).
• The study showed that up to 19% of EOC were
associated with endometriosis, while additional
studies also reported that younger women with
a diagnosis of endometriosis were at increased
risk of developing endometriosis-associated
ovarian carcinoma.
• Use of hormonal birth control methods have been
incorporated in both the treatment and regulation
of endometriosis, and the prevention of the
development of ovarian cancer (American Cancer
Society, 2018c).
Risk Factors for Ovarian Cancer
Depicted above are illustrated risk factors in developing ovarian cancer. Retrieved from
https://ovariancancer.net.au/understanding-the-risks/
Current strategies in preventing the development
of ovarian cancer need improvement. However,
certain interventions have taken place (Committee
on the State of the Science in Ovarian Cancer
Research, Board on Health Care Services, Institute
of Medicine, & National Academies of Sciences,
Engineering, and Medicine, 2016).
• Currently, the only real prevention and
intervention strategy that holistically prevents
the disease is Bilateral Salpingo-Oophorectomy
(BSO), also known as the risk-reducing salpingo-
oophorectomy (RRSO), which is the surgical
removal of the fallopian tubes and ovaries,
which dramatically reduces the risk of ovarian
cancer in women at average risk and high risk
due to inherited genetic susceptibility.
• However, the risk reduction achieved with RRSO
is not 100 percent, and the procedure is not
without inherent risks and side effects,
including early menopause, osteoporosis,
mortality. As such, no formal body has
recommended RRSO for the primary prevention
of ovarian cancer for the general population.
References
1. American Cancer Society. (2018, April 11) a. Signs and symptoms of ovarian cancer. Retrieved from
https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/signs-and-symptoms.html
2. American Cancer Society. (2018, April 11) b. What causes ovarian cancer | How do you get ovarian cancer.
Retrieved from https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/what-causes.html
3. American Cancer Society. (2018, April 11) c. How to prevent ovarian cancer | Oral contraceptives & ovarian
cancer. Retrieved from https://www.cancer.org/cancer/ovarian-cancer/causes-risks-
prevention/prevention.html
4. Brilhante, A. V., Agusto, K. L., Potela, M. C., Sucupira, L. C., Oliveira, L. A., Pouchaim, A. J., … Sobreira, L. B.
(2017, January 1). Endometriosis and ovarian cancer: An integrative review. Retrieved from
https://dx.doi.org/10.22034%2FAPJCP.2017.18.1.11
5. Cancer Research UK. (2019, August 15). Does obesity cause cancer? Retrieved from
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/obesity-weight-and-cancer/does-obesity-
cause-cancer#Obesity0
6. Centers for Disease Control and Prevention. (2019, July 29). Ovarian cancer statistics. Retrieved from
https://www.cdc.gov/cancer/ovarian/statistics/index.htm
7. Committee on the State of the Science in Ovarian Cancer Research, Board on Health Care Services, Institute
of Medicine, & National Academies of Sciences, Engineering, and Medicine. (2016, April 25). Prevention and
early detection | Ovarian cancers. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK367614/
8. Dinkelspiel, H. E., Champer, M., Hou, J., Terges, A., Burke, W. M., Huang, Y., … Wright, J. D. (2015, August).
Long-term mortality among women with epithelial ovarian cancer. Retrieved from
https://doi.org/10.1016/j.ygyno.2015.06.005
9. Herrinton, L. J., Neslund-Dudas, C., Rolnick, S. J., Hornbrook, M. C., Bachman, D. J., Darbinian, J. A., …
Coughlin, S. S. (2007, July 2). Complications at the end of life in ovarian cancer. Retrieved from
https://doi.org/10.1016/j.jpainsymman.2006.11.011
10. Leitzmann, M. F., Koebnick, C., Danforth, K. N., Brinton, L. A., Moore, S. C., Hollenbeck, A. R., ... Lacey, J. V.
(2009, January 6). Body mass index and risk of ovarian cancer. American Cancer Society, 115(4), 812-822.
Retrieved from https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.24086National Ovarian
Cancer Coalition. (2020, February 24). What is ovarian cancer? Retrieved from https://ovarian.org/about-
ovarian-cancer/what-is-ovarian-cancer
11. Office on Women's Health. (2019, April 1). Endometriosis. Retrieved from https://www.womenshealth.gov/a-
z-topics/endometriosis
12. Olsen, C. M., Nagle, C. M., Whiteman, D. C., Ness, R., Pearce, C. L., Pike, M. C., … Webb, P. M. (2018, August
7). Obesity and risk of ovarian cancer subtypes: Evidence from the ovarian cancer association consortium.
Retrieved from https://dx.doi.org/10.1530%2FERC-12-0395
13. World Health Organization. (n.d.). Obesity. Retrieved from https://www.who.int/topics/obesity/en/