Ovarian cancer in the world: Epidemiology and risk factors Original paper

What was reviewed?

This review article examines the global epidemiology of ovarian cancer, focusing on its incidence, mortality rates, and risk factors. It highlights the geographical disparities in ovarian cancer rates, with a particular focus on variations across different human development index (HDI) countries. Additionally, the article emphasizes the diverse range of risk factors, such as genetic predispositions, reproductive health factors, hormonal influences, and lifestyle factors, and their implications for ovarian cancer incidence.

Who was reviewed?

The review utilizes findings from a broad collection of studies on ovarian cancer published between 1925 and 2018. It includes data from observational studies on various aspects of ovarian cancer epidemiology, including incidence and mortality across different geographic regions and populations. The authors reviewed information on demographic, reproductive, genetic, hormonal, and lifestyle-related risk factors and their influence on the occurrence of ovarian cancer. No specific individuals were studied; rather, the article provides an overview of global trends and the factors contributing to ovarian cancer risk.

Most important findings

The review identifies several critical findings related to ovarian cancer’s global epidemiology. First, it highlights ovarian cancer as the seventh most common cancer among women, with significant variations in incidence and mortality rates across different regions. High-income countries tend to have higher incidence rates, although their mortality rates have been declining in recent years due to better access to treatment. In contrast, lower-income countries face higher mortality rates, attributed to limited healthcare access and late-stage diagnoses.

Genetic factors, particularly mutations in the BRCA1 and BRCA2 genes, play a significant role in increasing ovarian cancer risk, with familial history also contributing to susceptibility. Reproductive factors, including age at first menstruation, pregnancy, and lactation, were found to influence ovarian cancer risk, with early pregnancies and breastfeeding reducing the risk. Hormonal contraceptive use was also associated with a reduced risk of ovarian cancer. Additionally, lifestyle factors such as obesity, diet, and physical activity significantly impact ovarian cancer risk, with obesity being linked to higher cancer mortality rates. The article also discusses the role of pelvic inflammatory disease (PID) and endometriosis in increasing the likelihood of ovarian cancer, especially among women with chronic inflammation.

Key implications

The review’s findings suggest several implications for public health, especially in the context of prevention, early detection, and treatment strategies for ovarian cancer. Understanding the geographic disparities in incidence and mortality rates calls for targeted health interventions and increased access to diagnostic and treatment services, particularly in low-income countries. The recognition of genetic and reproductive factors as key determinants in ovarian cancer risk underscores the importance of genetic counseling and early screening for high-risk populations, particularly those with a family history of ovarian or breast cancer. Furthermore, the identification of lifestyle factors as modifiable risks opens opportunities for prevention strategies, including promoting healthy diets, regular physical activity, and weight management. The review also stresses the need for ongoing research to better understand the roles of chronic inflammation and reproductive health conditions like PID and endometriosis in ovarian cancer development.