HEREDITARY OVARIAN CANCER (OvCa)

OvCa is the 4th most frequent cancer diagnosed in women, occurring in about 1 in 55 women, with an average age at diagnosis of 61 years. The most common site of occurrence is the outer lining of the ovary, known as the epithelium.

90% of OvCa cases are not related to strong inherited factors.  Only about 5 to 10% of all cases of epithelial OvCa are hereditary or familial.

Risk Factors  

• OvCa in a 1st-degree relative (mother or sister) increases the risk 3-4 times over that of the general population
• positive family history (OvCa in other than first-degree relatives)
• early menstruation
• late menopause
• having no children or having them late in life
• use of infertility drugs without getting pregnant
• possibly the use of talcum powder

Ovarian Cancer and BRCA1/BRCA2 Gene Mutations 

The most common inherited syndrome associated with ovarian cancer is hereditary breast-ovarian cancer syndrome:

• Hereditary breast-ovarian cancer syndrome is associated with mutations in the BRCA1 and BRCA2 genes.
• • women with either BRCA1 or BRCA2 mutations have a significantly increased risk to develop ovarian cancer.
  • • for carriers of BRCA1 mutations, the risk is 40-60%
    • for carriers of BRCA2 mutations, the risk is 10-20%
  • the average age at diagnosis in women who carry BRCA1 or 2 mutations is approximately 50
  • carriers of these mutations also have an increased risk to develop breast cancer

OvCa is also seen in other hereditary cancer syndromes such as hereditary nonpolyposis colon cancer and hereditary site-specific ovarian cancer.

Protective Factors

• oral contraceptives in premenopausal women
• breast-feeding
• having children
• tubal ligation

Because sscreening for ovarian cancer has not been effective, options for high-risk women include:

• annual blood test and transvaginal ultrasound and color doppler studies
• annual physical examination by an obstetrician/gynecologist
• prophylactic oophrectomy (removal of healthy ovaries to avoid cancer)