Is ovarian cancer still considered a disease of the elderly?

Posted in ovarian cancer, diagnosis, demographics; Posted 2 years ago by Andreas Obermair

Ovarian cancer is mostly a disease diagnosed in elderly women. Ovarian cancer can be diagnosed at any age, although it usually occurs in women who have been through menopause. The average age of an ovarian cancer diagnosis is 64 years. It is mainly diagnosed in women over the age of 50, but there are cases diagnosed in younger women, too.

Epithelial ovarian cancers are the most common ovarian cancer types in women of age 50 years or older. These tumours arise from a tiny film of cells covering the entire ovary and fallopian tube, which is called the epithelium (therefore “epithelial” ovarian cancer).

Ovarian cancer is rare in women younger than 40 years. Ovarian cancers diagnosed in women under 40 years are mostly non-epithelial tumours. While uncommon, I have treated ovarian cancer in younger women, with the youngest case in a 16 year old patient. Younger women may be more likely to develop other subtypes of ovarian tumours. The most common types of ovarian tumours in younger women are:

• Borderline tumours. These are neither completely benign nor cancerous, but have low malignant potential. If left untreated they may become larger, spread and cause damage. They are treated by surgery and most patients have a good prognosis and a complete cure.
• Germ cell tumours develop in the egg cells within the ovary and generally only affect one ovary. Only 4% of women have these rare types of cancer, but they are mostly in women under the age of 40.
• Stromal cell tumours develop in the connective tissue parts of ovaries. Far less than 10% of all ovarian cancer account for this tumour type and most patients will have early-stage disease.

Causes of ovarian cancer

We don’t know exactly what causes ovarian cancer, however there are a number of factors that can increase ovarian cancer risk. Risk factors for ovarian cancers vary according to histologic type.

Risk factors for epithelial ovarian cancer include:

• Being over the age of 50 years.
• Family history of ovarian, breast or bowel cancer
• Being overweight or obese
• Changes in the genes BRCA1 or BRCA2
• Being of Ashkenazi Jewish descent due to a higher BRCA incidence
• Early onset of periods (before 12 years)
• Late menopause
• Women who have not had children
• Women who have their first full-term pregnancy after the age of 35
• Smoking, which may increase mucinous ovarian cancer
• Using oestrogen-only hormone replacement therapy
• Fertility treatment.

If one or more of these factors apply, it does not mean ovarian cancer will develop. It just means that the risk to develop ovarian cancer is slightly higher.

Overall, the risk of developing the most common type of ovarian cancer is small (1.3%) and increases in elderly women. Know the signs and symptoms and talk to your doctor if you have any concerns.

Non-epithelial ovarian cancers are very rare, so there isn’t as much research available on its causes and risk factors. We do know they are more likely to occur in girls and women between the ages of 10-30 years.

Ovarian cancer has the highest mortality rate amongst all gynaecological cancers, predominately due to a lack of symptoms in the early stages and no effective screening program, or reliable diagnostic tests. Overall, females diagnosed with all types and stages of ovarian cancer unfortunately still have a low survival rate, with an overall 48% chance of surviving for five years compared to the general Australian population. However, newer generations of medications (targeted treatments) have made massive inroads and improvements for patients whose tumours display specific features.

For more information on diagnosing ovarian cancer, visit the Ovarian Cancer page.

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