Prognostic implications of reproductive and lifestyle factors in ovarian cancer

Poole, Elizabeth M.; Konstantinopoulos, Panagiotis A.; Terry, Kathryn L.

doi:10.1016/j.ygyno.2016.05.014

Cited by 30 publications

(45 citation statements)

References 62 publications

(87 reference statements)

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Section: Accepted Manuscriptmentioning

confidence: 99%

“…Obese women may have poorer survival than their normal weight counterparts, perhaps, in part, due to the practice of dose-capping whereby obese women are not given the full chemotherapy dose for their body-size because of toxicity concerns [92]. A recent pooled analysis suggested women who were sedentary prior to diagnosis had worse outcomes [93] and others have reported benefits for those with a more healthy diet [94].However, these and most other studies are based on what women did prior to their diagnosis.Aside from the likely benefits of physical activity based on evidence from other cancer types [95], there is currently a lack of evidence to inform lifestyle advice for women after they are diagnosed with ovarian cancer.[3869 words] M A N U S C R I P T …”

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confidence: 99%

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Epidemiology of epithelial ovarian cancer

Webb

Jordan

2017

Best Practice & Research Clinical Obstetrics & Gynaecol

747

550

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Globally, ovarian cancer is the seventh most common cancer in women and the eighth most common cause of cancer death, with five-year survival rates below 45%. Although agestandardised rates are stable or falling in most high-income countries, they are rising in many low and middle income countries. Furthermore, with increasing life-expectancy, the number of cases diagnosed each year is increasing. To control ovarian cancer we need to understand the causes. This will allow better prediction of those at greatest risk for whom screening might be appropriate, while identification of potentially modifable causes provides an opportunity for intervention to reduce rates. In this paper we will summarise the current state of knowledge regarding the known and possible causes of epithelial ovarian cancer and discuss some of the main theories of ovarian carcinogenesis. We will also briefly review the relationship between lifestyle and survival after a diagnosis of ovarian cancer.[Words=148] KEY WORDSOvarian neoplasms; epidemiology; incidence; risk factors; survival M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 INTRODUCTIONGlobally, 240,000 women are diagnosed with ovarian cancer every year and, with five-year survival below 45%, it is responsible for 150,00 deaths making it the 7 th most common cancer and 8 th most common cause of cancer death among women [1]. Figure 1A shows that agestandardised incidence rates are highest in northern and central/eastern Europe, intermediate in north America, Australia and western Europe and lowest in Asia and Africa. Rates have been decreasing in most high incidence countries but increasing in many low incidence countries ( Figure 1B) thus the differences today are less marked than 30 years ago [2]. Rates also vary by ethnicity within countries such that in the United States, rates in non-Hispanic white women are approximately 30% higher than African-American and Asian women and 12% higher than Hispanic women [3].

Ovarian cancer is rare in women under 40 years of age and most cancers in this age group are germ cell tumours. Above age 40, more than 90% are epithelial tumours and the risk increases with age, peaking in the late 70s. Despite being classified as ovarian, a high proportion of highgrade serous cancers are now thought to originate from the fallopian tube. In the following discussion the term 'ovarian cancer' refers to epithelial cancers that arise in the ovary or fallopian tube as well as the histologically similar primary peritoneal cancers. RISK FACTORSIt is well established that women with a family history of ovarian cancer are themselves at higher risk of the disease. The risk for women with one affected first-degree relative is about three times that for women with no affected relatives [4], and even higher for those whose M A N U S C R I P T A C C E P T E D The following sections review non-genetic factors known or suspected to affect a woman's risk of developing epithelial ovarian cancer, with most weight given to recent meta-...

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Section: Accepted Manuscriptmentioning

confidence: 99%

mentioning

confidence: 99%

Epidemiology of epithelial ovarian cancer

Webb

Jordan

2017

Best Practice & Research Clinical Obstetrics & Gynaecol

747

550

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“…However, the literature has been mixed on the relationship between reproductive ovarian cancer risk factors and overall survival (Poole et al , 2016). One recent study noted improved survival for ovarian cancer patients with endometriosis (Melin et al , 2011); however, a 2014 meta-analysis of smaller studies reported no association after adjustment for covariates (Kim et al , 2014).…”

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confidence: 99%

Reproductive and hormonal factors in relation to survival and platinum resistance among ovarian cancer cases

et al. 2016

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“…If such findings were extended to prospective studies, it may be possible to identify individualized cut-points or changes over time based on participant characteristics that can improve early detection. Further, relatively few population-based studies have examined associations of pharmacologic and nonpharmacologic factors 17 , such as aspirin use and physical activity, which have been associated with survival for other cancers 18–20 . Given increasing evidence that pre-diagnosis risk factors influence tumor development, considering exposures both before and after diagnosis is required to fully characterize survivorship in ovarian cancer patients.…”

Section: Screening and Survivalmentioning

confidence: 99%