The American Cancer Society estimates that about 19,680 women in the US will be diagnosed with and about 12,740 will die of ovarian cancer in 2024¹. This is an important topic as many of us are affected by this disease, directly or indirectly. The good news: these numbers are actually slowly trending down. But the reality is a woman’s lifetime risk of developing ovarian cancer is 1 in 87¹. Why are these numbers so staggering? Will they continue to trend in the “right” direction. Let’s talk ovarian cancer basics, emerging evidence, and what we can do to help.

What is Ovarian Cancer?

Cancer is the overgrowth of abnormal cells. Ovarian cancer starts in the fallopian tubes or ovaries. Over the past several years evidence points toward majority (~70%) of ovarian cancers may originate in the fallopian tubes⁵. This is crucial to consider for future prevention, diagnosis, and treatment.

Risk Factors

• Women
• White or Native American
• Ashkenazi Jewish population are more likely to have BRCA mutation (increasing risk of breast and/or ovarian cancer)
• Age >60
• Family history
• Never being pregnant or having children later in life
• Endometriosis
• Obesity

Prevention

The US Preventative Services Task Force (USPSTF) recommends against routine screening for ovarian cancer in the general population. However, the American College of Obstetricians and Gynecologists (ACOG) and the Society of Gynecologic Oncologists (SGO) recommend that women at high risk be offered an evaluation. Unfortunately, there is not yet an effective routine screening test.³

Additionally, symptoms often do not develop until late stage and may include:

• Pelvic/abdominal pain and/or discomfort
• Appetite changes
• Abnormal bleeding
• GI symptoms (diarrhea, constipation)

It is important to have regular follow up with your primary care provider and gynecologist. Routine physical exams and blood work are part of advocating for your own health.

Diagnosis

Without routine screening and symptoms developing late stage, diagnosis is often delayed.

Below are diagnostic methods. The gold standard for diagnosis is tissue biopsy.

• Pelvic exam
• Imaging: ultrasound, CT, PET, MRI
• Blood work: CA-125 (non-specific cancer screening)
• Surgical intervention

Treatment

Treatment regimens and duration depend on staging. Individualized plans may include surgery and/or chemotherapy.

5 year survival rates⁴:

• Early stage 93.1%
• Intermediate stage 74.5%
• Late stage 30.8%

(includes those diagnosed between 2012 and 2018)

In Conclusion

A woman has a 1 in 87 chance of developing ovarian cancer in her lifetime. Over the past few decades incidence has steadily declined. However, some models predict ovarian cancer rates will start to climb again. There have been slow advancements in the cause, diagnosis, and treatment of this cancer. But we can do better. It starts with advocating for your own health. Because if you don’t who else will. Awareness is key. Know if you are at risk, follow up with your care team regularly, and take care of and listen to your body and mind.

As always, please reach out with questions, comments, or for further discussion.

Lindsey, PharmD, BCPS

References

¹American Cancer Society. (2024, January 19). Ovarian cancer statistics: How common is ovarian cancer. Ovarian Cancer Statistics | How Common is Ovarian Cancer | American Cancer Society. https://www.cancer.org/cancer/types/ovarian-cancer/about/key-statistics.html

²Cleveland Clinic. (2024, September 9). Ovarian cancer: Symptoms, diagnosis & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer

³Green, A. E. (2024, August 15). Ovarian cancer guidelines. Guidelines Summary, Risk Assessment and Genetic Counseling, Surgical Intervention for Ovarian Cancer Prevention. https://emedicine.medscape.com/article/255771-guidelines

⁴Moffitt Cancer Center. (n.d.). Ovarian cancer survival rate. Moffitt Cancer Center. https://www.moffitt.org/cancers/ovarian-cancer/survival-rate/

⁵National Cancer Institute . (2017, November 15). Many ovarian cancers may start in fallopian tubes. Many Ovarian Cancers May Start in Fallopian Tubes – NCI. https://www.cancer.gov/news-events/cancer-currents-blog/2017/ovarian-cancer-fallopian-tube-origins

⁶National Cancer Institute. (2024, May 17). Advances in ovarian cancer research. NCI. https://www.cancer.gov/types/ovarian/research