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Cancer is a disease in which certain cells of the body grow uncontrollably and spread to other parts of the body. While many forms of cancer can be detected in the early stages, ovarian cancer is often not noticed until it reaches advanced stages, making treatment more challenging. However, understanding the genetic risk factors associated with ovarian cancer may lead to earlier diagnosis, which may improve treatment outcomes.
Are genetics the only culprit?
Genetic mutations that can cause ovarian cancer occur in only 15–20% of cases. Some other risk factors include:
- Hormonal: Excessive estrogen exposure.
- Lifestyle Factors: Sedentary lifestyle and obesity contribute to higher risk of ovarian cancer
- Random chance: So, genetics are not the only culprit.
Reed BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med. 2017 Feb;14(1):9-32. doi:10.20892/j.issn.2095-3941.2016.0084. PMID: 28443200; PMCID: PMC5365187.
How to know genetic risk?
When considering genetic risk for ovarian cancer, we need to look at our family tree to identify if any of our close blood relatives (sister, mother, grandmother) or first- or second-degree cousins have the disease. This cancer has been diagnosed in. , If you find a patient there, you have a higher risk of getting the disease than the general population.
What if I have a family history?
The best way is to contact a gynecologist oncologist. There are some guidelines for testing in such circumstances. There is no need to test everyone for genetic risk. Often, such testing is combined with genetic counseling before and after testing and should be conducted by a geneticist. Such testing is not limited to ovarian cancer but can also be done for breast, pancreatic and prostate cancers.
Couples in the reproductive age group may face concerns about passing on such genes to the next generation. In such circumstances, preimplantation genetic testing is recommended.
What are my options if I test positive in genetic screening?
Again, your best option is to make an appointment with a gynecologic oncologist. The modalities available to such persons are:
- Non-Surgical Risk Reduction: The use of oral contraceptive pills and levonorgestrel intrauterine devices (IUDs) for ovulation suppression have been shown to reduce the risk of ovarian cancer in average-risk women.
- Surgical Risk Reduction: It involves the removal of both the fallopian tubes (salpingectomy) and ovaries (oophorectomy). The timing of surgery, early or late removal, depends on the genetic testing results.
Do children also need genetic testing?
According to NCCN guidelines, children under 18 years of age do not need genetic testing, as the results will not affect the medical management of such young patients.
Reference: NCCN Guideline Version 3,2024 Ovarian Cancer
Is there a screening test for ovarian cancer?
Unlike cervical cancer, there is no effective screening test for early detection of ovarian cancer; Therefore, screening is not recommended for women at average and low risk. But in case of high-risk women, transvaginal ultrasound, CA125, along with physical examination, can be done on a semi-annual basis. However, knowing about the symptoms, risk factors, and relevant genetic testing may provide a slight edge against this cancer.
Should this knowledge increase my anxiety?
No, a recent study in Britain rejected the idea that promoting knowledge about cancer increases anxiety. Such information has been received which reassures the public. It is important to empower individuals with the knowledge to take responsibility for their health and become good advocates for themselves.
Input by Dr. Satinder Kaur, Director, Gynecology Oncology, Max Super Specialty Hospital, Vaishali.
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