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Cancer of the Ovary, Fallopian Tube, and Uterine Tube

EPIDEMIOLOGY AND DIAGNOSIS

Approximately 26,800 women were diagnosed with ovarian cancer. Of these women, an estimated 14,200 will die of the disease, which represents 55% of all deaths from gynecologic cancer. The risk of a woman developing ovarian cancer during her lifetime is 1-2%. The incidence varies with age and is 1.4 per 100,000 in women under age 40 years and 38 per 100,000 in women older than age 60 years uterine cancer, uterus cancer. Figure 4 illustrates the prevalence of different types of ovarian cancer by age. Ovarian cancer is more common in Northern European and North American countries than in ovarian cancer, uterine cancer, uterus cancer, ovary cancer, overian

The etiology is not known, but risk of uterine cancer factors include infertility, low parity, or both; use of talc on the perineum; high-fat diet; lactose intolerance; history of breast or colon cancer; and a family history of. Smoking, alcohol use, coffee consumption, estrogen replacement therapy, and viral infections (such as mumps) have not been associated with increased risk. Use of oral contraceptives, however, is protective, with an average relative risk of about 0.7 for women who have used oral contraceptives for 2 years and a 0.5 relative risk for women who have used oral contraceptives for 5 years or more. The protective effect of oral contraceptive use appears to be long term, with some studies indicating a lifetime risk reduction.

Figure 5 illustrates the relationship of ovarian cancer to the other gynecologic cancers for both incidence and mortality. Table 6 illustrates the uterine cancer, uterus cancer relative stage at diagnosis and the survival by stage for ovarian cancer in relation to other gynecologic cancers. The 5-year survival rate for ovarian cancer by stage is not significantly different from the 5-year survival rate for other gynecologic cancers; however, there is a significant difference in stages, usually having spread into the abdomen in about two thirds of patients at the time of diagnosis. It is clear from these data that the single most important factor in the large number of deaths from ovarian cancer is the failure to diagnosis the disease at an early stage. The reasons for this failure correspond to the growth and spread patterns of the disease. Because the ovary floats freely in the pelvic cavity, a tumor can grow for some time without producing symptoms associated with involvement of, or pressure on, other organs.

SCREENING

One of the most significant ways to improve survival for patients would be to find a way to screen women for and detect the disease before it spreads beyond the ovary. Currently available methods for screening for ovarian cancer are pelvic examination, serum CA 125 level measurements, and pelvic or transvaginal ul-trasonography. To date,

Stage at Diagnosis and 5-Year Survival Rate of

Treatment