The Importance of Early Detection of Ovarian Cancer: Epidemiology and Risk Factors
Abstract
Background: Although not having a high incidence, ovarian cancer still leads to the most common cancer-related death among women diagnosed with gynecologic malignancies. The present study aims to highlight this disease’s epidemiology, risk factors, and the significance of developing improved early detection strategies.Methods: Articles were accessed from PubMed and Google Scholar without a time limit. Full-text English studies that mentioned epidemiology and risk factors of ovarian cancer were included in this review.Results: The highest incidence and mortality rates are observed in Central and Eastern Europe, while rates are relatively low in some parts of Asia and Africa. The risk factors for this disease include family history, hormonal factors, nutrition, diet, and physical activity. We also discussed some protective factors. There are no reliablescreening methods for ovarian cancers. The most common diagnostic methods include a pelvic exam, a transvaginal ultrasound, and several imaging tests.Conclusions: The mortality rate of ovarian cancer is gradually increasing; thus, preventative measures are required to reduce the lifetime risk of ovarian cancer and improve the mortality rate.
1. American Cancer Society. Cancer Facts & Figures 2022. Atlanta, Ga: American Cancer Society; 2022.
2. Colombo N, Sessa C, Bois A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Annals of Oncology. 2019; 30: 672-705.
3. Cancer of the Ovary - Cancer Stat Facts [Internet]. SEER. 2022 Accessed 27 April 2022. Available from: https://seer.cancer.gov/statfacts/html/ovary.html.
4. Benedet JL, Bender H, Jones H, Ngan HY, Pecorelli S. FIGO staging classifications and clinical practice guidelines in the management of gynecologic can¬cers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet 2000;70(2): 209–262.
5. Heintz A, Odicino F, Maisonneuve P, et al. Carcino¬ma of the Ovary. Int Journal of Obstetrics & Gynae¬cology. 2006; 95: S161-S192.
6. Lopez J, Banerjee S, Kaya SB. New development in treatment of ovarian cancer_future prospective. An¬nals of Oncology. 2013; 24: 69-76.
7. Coleman MP, Forman D, Bryant H. The ICBP mod¬ule 1 working group cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the international cancer benchmarking partnership): an analysis of population-based cancer registry data. Lancet. 2011; 377: 127-138.
8. Bray F, Loos AH, Tognazzo S, La Vecchia C. Ovarian cancer in Europe: Cross-sectional trends in incidence and mortality in 28 countries, 1953–2000. Int J Can¬cer. 2005; 113: 977–990.
9. Parazzini F, Franceschi S, La Vecchia C, Fasoli M. The epidemiology of ovarian cancer. Gynecologic Oncology.1991; 43: 9–23.
10. Sopik V, Iqbal J, Rosen B, Narod SA. Why have ovari¬an cancer mortality rates declined? Part I. Incidence. Gynecologic Oncology. 2015; 138: 741-749.
11. Stratton JF, Pharoah P, Smith SK, Easton D, Ponder BAJ. A systematic review and meta‐analysis of family history and risk of ovarian cancer. Br J Obstet Gynae¬col. 1998; 105: 493‐499.
12. Jervis S, Song H, Lee A, et al. Ovarian cancer famil¬ial relative risks by tumour subtypes and by known ovarian cancer genetic susceptibility variants. J Med Genet. 2014; 51: 108‐ 113.
13. Frank TS, Manley SA, Olopade OI, et al. Sequence analysis of BRCA1 and BRCA2: correlation of mu¬tations with family history and ovarian cancer risk. J Clin Oncol. 1998; 16: 2417–2425.
14. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of breast, ovarian, and contralateral breast can¬cer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017; 317: 2402-2416.
15. Malander S, Ridderheim M, Masback A, et al. One in 10 ovarian cancer patients carry germ line BRCA1 or BRCA2 mutations: results of a prospective study in Southern Sweden. Eur J Cancer. 2004; 40: 422–428.
16. Tung KH, Goodman MT, Wu AH, et al. Reproductive factors and epithelial ovarian cancer risk by histolog¬ic type: a multiethnic case-control study. Am J Epide¬miol. 2003; 158: 629-638.
17. Tsilidis KK, Allen NE, Key TJ, et al. Oral contracep¬tive use and reproductive factors and risk of ovari¬an cancer in the European Prospective Investigation into Cancer and Nutrition. Br J Cancer. 2011; 105: 1436-1442.
18. Royar J, Becher H, Chang-Claude J. Low-dose oral contraceptives: protective effect on ovarian cancer risk. Int J Cancer. 2001; 95: 370-374.
19. Rasmussen ELK, Hannibal CG, Dehlendorff C, et al. Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study. Gynecologic Oncol. 2017; 144: 571-576.
20. Ness RB, Grisso JA, Klapper J, et al. Risk of Ovarian Cancer in Relation to Estrogen and Progestin Dose and Use Characteristics of Oral Contraceptives. American Journal of Epidemiology. 2000;152(3):233– 241. doi: 10.1093/aje/152.3.233
21. Kim SJ, Rosen B, Fan I, et al. Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer. Br J Cancer. 2017; 116: 964. doi: 10.1038/bjc.2017.35
22. Mori M, Harabuchi I, Miyake H, Casagrande JT, Henderson BE, Ross RK. Reproductive, genetic, and dietary risk factors for ovarian cancer. Am J Epidemi¬ol. 1988; 128: 771–777.
23. Le D-C, Kubo T, Fujino Y, Sokal DC, Vach TH, Pham T-M, et al. Reproductive factors in relation to ovarian cancer: a case–control study in Northern Vietnam. Contraception. 2012; 86: 494–9.
24. Salazar-Martinez E, Lazcano-Ponce EC, Gonzalez Li¬ra-Lira G, Escudero-De Los Rios P, Salmeron-Castro J, Hernandez-Avila M. Reproductive factors of ovari¬an and endometrial cancer risk in a high fertility pop¬ulation in Mexico. Cancer Res. 1999; 59: 3658–3662.
25. Moorman P, Schildkraut J, Calingaert B, Hala¬bi S, Vine M, Berchuck A. Ovulation and ovarian cancer: a comparison of two methods for calcu¬lating lifetime ovulatory cycles (United States). Cancer Causes Control. 2002; 13: 807–811. doi: 10.1023/A:1020678100977.
26. Riman T, Dickman PW, Nilsson S, et al. Risk factors for epithelial borderline ovarian tumors: results of a Swedish case-control study. Gynecol Oncol. 2001; 83: 575–585. doi: 10.1006/gyno.2001.6451.
27. Huusom LD, Frederiksen K, Hogdall EV, et al. Asso¬ciation of reproductive factors, oral contraceptive use and selected lifestyle factors with the risk of ovarian borderline tumors: a Danish case-control study. Can¬cer Causes Control. 2006; 17: 821–829. doi: 10.1007/ s10552-006-0022-x.
28. Toufakis V, Katuwal S, Pukkala E, Tapanainen JS. Impact of parity on the incidence of ovarian cancer subtypes: a population-based case–control study. Acta Oncologica. 2021; 60: 850–5.
29. Moorman PG, Calingaert B, Palmieri RT, et al. Hor¬monal risk factors for ovarian cancer in premenopau¬sal and postmenopausal women. Am J Epidemiol. 2008; 167: 1059–1069. doi: 10.1093/aje/kwn006.
30. Yang CY, Kuo HW, Chiu HF. Age at first birth, parity, and risk of death from ovarian cancer in Taiwan: a country of low incidence of ovarian cancer. Int J Gy¬necol Cancer. 2007; 17(1): 32–36.
31. Arthur RS, Kirsh VA, Rohan TE. Dietary B-Vitamin Intake and Risk of Breast, Endometrial, Ovarian and Colorectal Cancer among Canadians. Taylor & Fran¬cis Online. 2019; 71: 1067-1077.
32. Schulz M, Lahmann PH, Riboli E, Boeing H. Dietary determinants of epithelial ovarian cancer: a review of the epidemiologic literature. Nutr Cancer. 2004; 50: 120–140.
33. Larsson SC, Holmberg L, Wolk A. Fruit and vegeta¬ble consumption in relation to ovarian cancer inci¬dence: the Swedish Mammography Cohort. Br J Can¬cer. 2004; 90: 2167–70.
34. Blank MM, Wentzensen N, Murphy MA, Hollenbeck A, Park Y. Dietary fat intake and risk of ovarian can¬cer in the NIH-AARP Diet and Health Study. Br J Cancer. 2012; 106(3): 596–602.
35. Larsson SC, Bergkvist L, Wolk A. Milk and lactose in¬takes and ovarian cancer risk in the Swedish Mammog¬raphy Cohort. Am J Clin Nutr. 2004; 80(5): 1353–57.
36. Cottreau CM, Ness RB, Kriska AM. Physical activity and reduced risk of ovarian cancer. Obstet Gynecol. 2000; 96: 609-614.
37. Pan SY, Ugnat AM, Mao Y. Physical activity and the risk of ovarian cancer: A case‐control study in Cana¬da. Int Journal of Cancer. 2005; 117: 300-307
38. Bertone ER, Newcomb PA, Willett WC, Stampfer MJ, Egan KM. Recreational physical activity and ovarian cancer in a population-based case-control study. Int J Cancer 2002;99:431–6.
39. Bain C, Purdie D, Green A, et al. Exercise may protect against ovarian cancer. Am J Epidemiol 1996;143:72.
40. Zhang M, Lee AH, Binns CW. Physical activity and epithelial ovarian cancer risk: a case-control study in China. Int J Cancer 2003;105:838–43.
41. Leitzmann MF, Koebnick C, Moore SC, et al. Prospec¬tive study of physical activity and the risk of ovarian cancer. Cancer Causes Control. 2009; 20: 765-773.
42. Bertone ER, Willett WC, Rosner BA, et al. Prospective Study of Recreational Physical Activity and Ovarian Cancer. JNCI: Journal of the National Cancer Insti¬tute. 2001; 93: 942-948.
43. Delort L, Kwiatkowski F, Chalabi N, Satih S, Bignon YJ, Bernard-Gallon DJ. Central adiposity as a ma¬jor risk factor of ovarian cancer. Anticancer Res. 2009;29(12):5229–5234.
44. Rodriguez C, Calle EE, Fakhrabadi-Shokoohi D, Jacobs EJ, Thun MJ. Body mass index, height, and the risk of ovarian cancer mortality in a prospective cohort of postmenopausal women. Cancer Epidemi¬ol Biomarkers Prev. 2002;11(9):822–828.
45. Beehler GP, Sekhon M, Baker JA, et al. Risk of ovari¬an cancer associated with BMI varies by menopausal status. J Nutr. 2006;136(11):2881–2886. doi: 10.1093/ jn/136.11.2881
46. Torpy JM, Burke AE, Golub RM. Ovarian cancer. JAMA. 2011; 305: 2484-2484.
47. Torre LA, Trabert B, DeSantis CE, Miller KD, Sami¬mi G, Runowicz CD, et al. Ovarian cancer statis¬tics, 2018. CA: A Cancer Journal for Clinicians. 2018;68(4):284–96.
48. Goff BA, Mandel LS, Melancon CH, Muntz HG. Fre¬quency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA. 2004; 291: 2705–2712.
49. Survival rates for ovarian cancer, by stage. American Cancer Society. Accessed 11 April 2021 https://www. cancer.org/cancer/ovarian-cancer/detection-diagno¬sis-staging/survival-rates.html.
50. Lu KH. Screening for ovarian cancer in asymptomat¬ic women. JAMA. 2018; 319: 557-558.
51. Jacobs IJ, Menon U, Ryan A, et al. Ovarian cancer screening and mortality in the UK Collaborative Tri¬al of Ovarian Cancer Screening (UKCTOCS): a ran¬domised controlled trial. Lancet. 2016; 387: 945-956.
52. Buys S, Partridge E, Greene M, et al. Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovar¬ian (PLCO) cancer screening trial: Findings from the initial screen of a randomized trial. American Journal of Obstetrics and Gynecology. 2005; 193: 1630-1639.
53. Ebell MH, Culp M, Lastinger K, Dasigi T. A Systemat¬ic Review of the Bimanual Examination as a Test for Ovarian Cancer. Obstetrical & Gynecological Survey. 2015;70(5):323–4.
54. van Nagell JR, DePriest PD, Ueland FR, DeSimone CP, Cooper AL, McDonald JM, et al. Ovarian can¬cer screening with annual transvaginal sonography. Cancer. 2007;109(9):1887–96.
55. Thabet A, Somarouthu B, Oliva E, Gervais DA, Hahn PF, Lee SI. Image-Guided Ovarian Mass Biopsy: Ef¬ficacy and Safety. Journal of Vascular and Interven¬tional Radiology. 2014;25(12):1922-1927.e1.
56. Stevens SK, Hricak H, Stern JL. Ovarian lesions: detec¬tion and characterization with gadolinium enhanced MR imaging at 1.5 T. Radiology. 1991;181:481–488
57. Rieber A, Nussle K, Stohr I, et al. Preoperative diag¬nosis of ovarian tumors with MR imaging: compar¬ison with transvaginal sonography, positron emis¬sion tomography, and histologic findings. AJR. 2001; 177:123 –129.
2. Colombo N, Sessa C, Bois A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Annals of Oncology. 2019; 30: 672-705.
3. Cancer of the Ovary - Cancer Stat Facts [Internet]. SEER. 2022 Accessed 27 April 2022. Available from: https://seer.cancer.gov/statfacts/html/ovary.html.
4. Benedet JL, Bender H, Jones H, Ngan HY, Pecorelli S. FIGO staging classifications and clinical practice guidelines in the management of gynecologic can¬cers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet 2000;70(2): 209–262.
5. Heintz A, Odicino F, Maisonneuve P, et al. Carcino¬ma of the Ovary. Int Journal of Obstetrics & Gynae¬cology. 2006; 95: S161-S192.
6. Lopez J, Banerjee S, Kaya SB. New development in treatment of ovarian cancer_future prospective. An¬nals of Oncology. 2013; 24: 69-76.
7. Coleman MP, Forman D, Bryant H. The ICBP mod¬ule 1 working group cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the international cancer benchmarking partnership): an analysis of population-based cancer registry data. Lancet. 2011; 377: 127-138.
8. Bray F, Loos AH, Tognazzo S, La Vecchia C. Ovarian cancer in Europe: Cross-sectional trends in incidence and mortality in 28 countries, 1953–2000. Int J Can¬cer. 2005; 113: 977–990.
9. Parazzini F, Franceschi S, La Vecchia C, Fasoli M. The epidemiology of ovarian cancer. Gynecologic Oncology.1991; 43: 9–23.
10. Sopik V, Iqbal J, Rosen B, Narod SA. Why have ovari¬an cancer mortality rates declined? Part I. Incidence. Gynecologic Oncology. 2015; 138: 741-749.
11. Stratton JF, Pharoah P, Smith SK, Easton D, Ponder BAJ. A systematic review and meta‐analysis of family history and risk of ovarian cancer. Br J Obstet Gynae¬col. 1998; 105: 493‐499.
12. Jervis S, Song H, Lee A, et al. Ovarian cancer famil¬ial relative risks by tumour subtypes and by known ovarian cancer genetic susceptibility variants. J Med Genet. 2014; 51: 108‐ 113.
13. Frank TS, Manley SA, Olopade OI, et al. Sequence analysis of BRCA1 and BRCA2: correlation of mu¬tations with family history and ovarian cancer risk. J Clin Oncol. 1998; 16: 2417–2425.
14. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of breast, ovarian, and contralateral breast can¬cer for BRCA1 and BRCA2 mutation carriers. JAMA. 2017; 317: 2402-2416.
15. Malander S, Ridderheim M, Masback A, et al. One in 10 ovarian cancer patients carry germ line BRCA1 or BRCA2 mutations: results of a prospective study in Southern Sweden. Eur J Cancer. 2004; 40: 422–428.
16. Tung KH, Goodman MT, Wu AH, et al. Reproductive factors and epithelial ovarian cancer risk by histolog¬ic type: a multiethnic case-control study. Am J Epide¬miol. 2003; 158: 629-638.
17. Tsilidis KK, Allen NE, Key TJ, et al. Oral contracep¬tive use and reproductive factors and risk of ovari¬an cancer in the European Prospective Investigation into Cancer and Nutrition. Br J Cancer. 2011; 105: 1436-1442.
18. Royar J, Becher H, Chang-Claude J. Low-dose oral contraceptives: protective effect on ovarian cancer risk. Int J Cancer. 2001; 95: 370-374.
19. Rasmussen ELK, Hannibal CG, Dehlendorff C, et al. Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study. Gynecologic Oncol. 2017; 144: 571-576.
20. Ness RB, Grisso JA, Klapper J, et al. Risk of Ovarian Cancer in Relation to Estrogen and Progestin Dose and Use Characteristics of Oral Contraceptives. American Journal of Epidemiology. 2000;152(3):233– 241. doi: 10.1093/aje/152.3.233
21. Kim SJ, Rosen B, Fan I, et al. Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer. Br J Cancer. 2017; 116: 964. doi: 10.1038/bjc.2017.35
22. Mori M, Harabuchi I, Miyake H, Casagrande JT, Henderson BE, Ross RK. Reproductive, genetic, and dietary risk factors for ovarian cancer. Am J Epidemi¬ol. 1988; 128: 771–777.
23. Le D-C, Kubo T, Fujino Y, Sokal DC, Vach TH, Pham T-M, et al. Reproductive factors in relation to ovarian cancer: a case–control study in Northern Vietnam. Contraception. 2012; 86: 494–9.
24. Salazar-Martinez E, Lazcano-Ponce EC, Gonzalez Li¬ra-Lira G, Escudero-De Los Rios P, Salmeron-Castro J, Hernandez-Avila M. Reproductive factors of ovari¬an and endometrial cancer risk in a high fertility pop¬ulation in Mexico. Cancer Res. 1999; 59: 3658–3662.
25. Moorman P, Schildkraut J, Calingaert B, Hala¬bi S, Vine M, Berchuck A. Ovulation and ovarian cancer: a comparison of two methods for calcu¬lating lifetime ovulatory cycles (United States). Cancer Causes Control. 2002; 13: 807–811. doi: 10.1023/A:1020678100977.
26. Riman T, Dickman PW, Nilsson S, et al. Risk factors for epithelial borderline ovarian tumors: results of a Swedish case-control study. Gynecol Oncol. 2001; 83: 575–585. doi: 10.1006/gyno.2001.6451.
27. Huusom LD, Frederiksen K, Hogdall EV, et al. Asso¬ciation of reproductive factors, oral contraceptive use and selected lifestyle factors with the risk of ovarian borderline tumors: a Danish case-control study. Can¬cer Causes Control. 2006; 17: 821–829. doi: 10.1007/ s10552-006-0022-x.
28. Toufakis V, Katuwal S, Pukkala E, Tapanainen JS. Impact of parity on the incidence of ovarian cancer subtypes: a population-based case–control study. Acta Oncologica. 2021; 60: 850–5.
29. Moorman PG, Calingaert B, Palmieri RT, et al. Hor¬monal risk factors for ovarian cancer in premenopau¬sal and postmenopausal women. Am J Epidemiol. 2008; 167: 1059–1069. doi: 10.1093/aje/kwn006.
30. Yang CY, Kuo HW, Chiu HF. Age at first birth, parity, and risk of death from ovarian cancer in Taiwan: a country of low incidence of ovarian cancer. Int J Gy¬necol Cancer. 2007; 17(1): 32–36.
31. Arthur RS, Kirsh VA, Rohan TE. Dietary B-Vitamin Intake and Risk of Breast, Endometrial, Ovarian and Colorectal Cancer among Canadians. Taylor & Fran¬cis Online. 2019; 71: 1067-1077.
32. Schulz M, Lahmann PH, Riboli E, Boeing H. Dietary determinants of epithelial ovarian cancer: a review of the epidemiologic literature. Nutr Cancer. 2004; 50: 120–140.
33. Larsson SC, Holmberg L, Wolk A. Fruit and vegeta¬ble consumption in relation to ovarian cancer inci¬dence: the Swedish Mammography Cohort. Br J Can¬cer. 2004; 90: 2167–70.
34. Blank MM, Wentzensen N, Murphy MA, Hollenbeck A, Park Y. Dietary fat intake and risk of ovarian can¬cer in the NIH-AARP Diet and Health Study. Br J Cancer. 2012; 106(3): 596–602.
35. Larsson SC, Bergkvist L, Wolk A. Milk and lactose in¬takes and ovarian cancer risk in the Swedish Mammog¬raphy Cohort. Am J Clin Nutr. 2004; 80(5): 1353–57.
36. Cottreau CM, Ness RB, Kriska AM. Physical activity and reduced risk of ovarian cancer. Obstet Gynecol. 2000; 96: 609-614.
37. Pan SY, Ugnat AM, Mao Y. Physical activity and the risk of ovarian cancer: A case‐control study in Cana¬da. Int Journal of Cancer. 2005; 117: 300-307
38. Bertone ER, Newcomb PA, Willett WC, Stampfer MJ, Egan KM. Recreational physical activity and ovarian cancer in a population-based case-control study. Int J Cancer 2002;99:431–6.
39. Bain C, Purdie D, Green A, et al. Exercise may protect against ovarian cancer. Am J Epidemiol 1996;143:72.
40. Zhang M, Lee AH, Binns CW. Physical activity and epithelial ovarian cancer risk: a case-control study in China. Int J Cancer 2003;105:838–43.
41. Leitzmann MF, Koebnick C, Moore SC, et al. Prospec¬tive study of physical activity and the risk of ovarian cancer. Cancer Causes Control. 2009; 20: 765-773.
42. Bertone ER, Willett WC, Rosner BA, et al. Prospective Study of Recreational Physical Activity and Ovarian Cancer. JNCI: Journal of the National Cancer Insti¬tute. 2001; 93: 942-948.
43. Delort L, Kwiatkowski F, Chalabi N, Satih S, Bignon YJ, Bernard-Gallon DJ. Central adiposity as a ma¬jor risk factor of ovarian cancer. Anticancer Res. 2009;29(12):5229–5234.
44. Rodriguez C, Calle EE, Fakhrabadi-Shokoohi D, Jacobs EJ, Thun MJ. Body mass index, height, and the risk of ovarian cancer mortality in a prospective cohort of postmenopausal women. Cancer Epidemi¬ol Biomarkers Prev. 2002;11(9):822–828.
45. Beehler GP, Sekhon M, Baker JA, et al. Risk of ovari¬an cancer associated with BMI varies by menopausal status. J Nutr. 2006;136(11):2881–2886. doi: 10.1093/ jn/136.11.2881
46. Torpy JM, Burke AE, Golub RM. Ovarian cancer. JAMA. 2011; 305: 2484-2484.
47. Torre LA, Trabert B, DeSantis CE, Miller KD, Sami¬mi G, Runowicz CD, et al. Ovarian cancer statis¬tics, 2018. CA: A Cancer Journal for Clinicians. 2018;68(4):284–96.
48. Goff BA, Mandel LS, Melancon CH, Muntz HG. Fre¬quency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA. 2004; 291: 2705–2712.
49. Survival rates for ovarian cancer, by stage. American Cancer Society. Accessed 11 April 2021 https://www. cancer.org/cancer/ovarian-cancer/detection-diagno¬sis-staging/survival-rates.html.
50. Lu KH. Screening for ovarian cancer in asymptomat¬ic women. JAMA. 2018; 319: 557-558.
51. Jacobs IJ, Menon U, Ryan A, et al. Ovarian cancer screening and mortality in the UK Collaborative Tri¬al of Ovarian Cancer Screening (UKCTOCS): a ran¬domised controlled trial. Lancet. 2016; 387: 945-956.
52. Buys S, Partridge E, Greene M, et al. Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovar¬ian (PLCO) cancer screening trial: Findings from the initial screen of a randomized trial. American Journal of Obstetrics and Gynecology. 2005; 193: 1630-1639.
53. Ebell MH, Culp M, Lastinger K, Dasigi T. A Systemat¬ic Review of the Bimanual Examination as a Test for Ovarian Cancer. Obstetrical & Gynecological Survey. 2015;70(5):323–4.
54. van Nagell JR, DePriest PD, Ueland FR, DeSimone CP, Cooper AL, McDonald JM, et al. Ovarian can¬cer screening with annual transvaginal sonography. Cancer. 2007;109(9):1887–96.
55. Thabet A, Somarouthu B, Oliva E, Gervais DA, Hahn PF, Lee SI. Image-Guided Ovarian Mass Biopsy: Ef¬ficacy and Safety. Journal of Vascular and Interven¬tional Radiology. 2014;25(12):1922-1927.e1.
56. Stevens SK, Hricak H, Stern JL. Ovarian lesions: detec¬tion and characterization with gadolinium enhanced MR imaging at 1.5 T. Radiology. 1991;181:481–488
57. Rieber A, Nussle K, Stohr I, et al. Preoperative diag¬nosis of ovarian tumors with MR imaging: compar¬ison with transvaginal sonography, positron emis¬sion tomography, and histologic findings. AJR. 2001; 177:123 –129.
| Files | ||
| Issue | Vol 13 No 3 (2021) | |
| Section | Reviews | |
| DOI | https://doi.org/10.18502/bccr.v13i3.11405 | |
| Keywords | ||
| Diagnosis Epidemiology Incidence Ovarian Cancer Risk Factors Screening | ||
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How to Cite
1.
Hardikar N. The Importance of Early Detection of Ovarian Cancer: Epidemiology and Risk Factors. Basic Clin Cancer Res. 2022;13(3):201-209.
