The uncertainty around risk factors associated with ovarian cancer continues to be a source of concern. While the presence of risk factors does not always spell doom, physicians and women should be aware of elements that can raise the risk of developing the disease:

• • Genetic syndromes: Approximately 10% to 12% of cases are associated with genetic syndromes. In particular, the presence of the BRCA mutation can be relevant.²
  • Age: More than 75% of women are diagnosed starting from their 40s to 60s. Often, they are diagnosed with advanced stages of cancer.^{2, 3}
  • Family history of cancer and/or previous diagnosis of cancer (ovarian, breast, colon, other)^{2, 4}
  • Never having children³
  • Obesity^{2, 4}
  • Hormone replacement therapy (risk may increase with length of use)²
  • History of endometriosis³

Physicians should take note of risk factors when conducting periodic physicals and take advantage of opportunities to educate patients on the types of risk that could contribute to the occurrence of ovarian cancer.

When ovarian cancer is a possibility, multiple diagnostic strategies are often needed to make the best assessment and determine the next steps. In addition to a thorough evaluation of patient history, a physician will perform a thorough physical exam. This generally includes a pelvic and abdominal exam to search for a cyst, tumor or other mass.

In some cases, imaging might also be considered if a physician detects a mass, if a physical examination cannot be completed properly, or if some other circumstance raises suspicion. Imaging sheds more light on the situation, giving physicians a better view of internal anatomy and increasing the chances of detecting an abnormality, should one exist. A variety of imaging tests are available, with transvaginal ultrasound being common in the early stages of evaluation.

Because a mass may not always be detected even when ovarian cancer is present, physicians may also use laboratory tests. One biomarker that is commonly evaluated is CA 125. Research has shown this to be a useful tool, although its utility can vary based on the disease risk and stage.² Patients with a strong family history of ovarian cancer may also benefit from further genetic testing.

Detection of suspicious masses and other results outside the norms dictated by current guidelines are often good reasons for referral to a gynecological oncologist. This specialist can use additional evaluations and tests to make a definitive determination as to whether a patient has ovarian cancer.