Epidemiology of ovarian malignancies
Keywords:Ovarian Malignancies, Ovarian tumours, Epidemiology
Background: The location of the ovaries makes it difficult to diagnose ovarian cancer at an earlier more curable stage. This study was done with intend of developing insight into risk factors, clinical presentation and prognostic factors for the same.
Methods: An observational prospective study was undertaken over a period of 2 years of 77 cases in a tertiary care hospital with cancer unit. Case records of cases during study period were evaluted and epidemiology studied.
Results: Most of the malignant tumors i.e. 35.1% were in the age group of 40- 50 yrs and 42 % of tumors seen in the age group of 41-60 years. 9.1% were post hysterectomy, 46.8% were premenopausal and 44.2% were postmenstrual. Majority cases were parous women and none had used oral contraceptive pills. In the present study, blood group A was found more commonly more commonly associated with ovarian tumors in comparison to the general population. the most common complaint of the patient was pain in abdomen (70.1%) followed by distension of abdomen (45.5%) and menstrual irregularities (16.9 %).
Conclusions: The epidemiology and presentation of ovarian tumours has remained unchanged since last 3 decades. Nulliparity is not as significant a factor in the aetiology of ovarian malignancy however contraception leading to anovulatory cycles (OC pills) may have a protective role. Infertility can be suggested as a risk factor but the treatment for infertility & its role in oncogenesis remains controversial.
Seidman JD, Kurman RJ. Sub classification of serous borderline tumours of the ovary into benign and malignant types: a clinicopathologic study of 65 advanced stage cases. Am J Clin Oncol. 1995;13:2752-6.
S Shah. Incidence and Management of Ovarian Tumours. Bombay Hospital Journal. 2008;50(1).
Mani R, Jamil K, Vamsy MC. Trends in medical research. 2007;2(3):128-34.
Basu P. personal communication from a pattern of care study on ovarian cancer patients. 2008.
Purdie DM, Bain CJ, Siskind V. Ovulation and risk of epithelial ovarian cancer. Int J Cancer. 2003;104:228-32.
Averette HE, Hoskins W, Nguyen HN. National survey of ovarian carcinoma. I. A Patient care evaluation study of the American College of Surgeons. Cancer. 1993;71:1629.
Fatimah Zahra. Parity and epithelial ovarian tumours. Pak J Med Health Sci. 2007;1(1):45-8.
Jekyll JF, Katz DL. Elmore JG, Wild DM. Epidemiology, Biostatistics, and Preventive Medicine. Philadelphia: Saunders. 2007.
Meirow D, Schenker JG. The link between female infertility and cancer: epidemiology and possible actiologies. Hum Reprod update. 1996;2(1):63-75.
Ness RB, Cottreau C. Possible role of ovarian epithelial inflammation in ovarian cancer. J Natl Cancer Inst. 1999;91(17):1459-67.
Ness RB, Grisso JA, Cottreau C et al. Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer. Epidemiology. 2000;11:111.
Ness RB. Endometriosis and ovarian cancer: thoughts on shared pathophysiology. Am J Obst Gyn. 2003;189(1):280-94.
Yoshikawa H, Jimbo H, Okala S. Prevalence of endometriosis in ovarian cancer. Gyn Obs Invest. 2000;50(1):11-7.
Mahdavi A, Pejovic T, Nerhot F. Induction of ovulation and ovarian cancer: a critical review of the literature. Ferti Steril. 2006;85(4):819-26.
Henderson J, Seagroatt V, Goldacre M. Ovarian cancer and ABO blood groups. J Epidemiol Community Health. 1993;47(4):287-9.
Bjökholm E. Blood group distribution in women with ovarian cancer. International Journal of Epidemiology. 1984;13:15–17.
Wernli KJ, Ray RM. Occupational exposures and ovarian cancer in textile workers. Epidemiology Cambridge Mass. 2000;19,(2):244-50.
Sheilds T, Gridley G. Occupational exposures and the risk of ovarian cancer in Sweden. American journal of Industrial Medicine. 2002;42,(3):200-13.
Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA. 2004;291:2705-12.
Olsen SH, Mignone L, Nakraseive C. Symptoms of ovarian cancer. Obstetric Gynecol. 2001;98(2):212-7.