Ovarian Cancer: Prevention

To prevent ovarian cancer (ovarian cancer), attention must be paid to reducing individual risk factors.

Behavioral risk factors

  • Diet
    • Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
  • Overweight (BMI ≥ 25; obesity) (+ 10%).

Medication

  • Hormone therapy (HT) after menopause (the time of the last spontaneous menstrual period in a woman’s lifetime) – regardless of the type of HT (estrogen or an estrogen-progestin combination) – promotes the development of ovarian cancer. The Collaborative Group on Epidemiological Studies of Ovarian Cancer individually analyzed and pooled data from all relevant epidemiological studies:
    • Women who had received HT at any time had a 20% higher relative risk of cancer than women who never received HT.
    • Women who had just undergone HT were at highest risk. Their risk – studied prospectively – was 41% higher than that of never-HT users.
    • Women who had stopped HT but who had been on it for less than five years still had a 23% increased risk of ovarian cancer.
  • Menopausal hormone replacement therapy; 43% increase in risk after 5 years; declines only slowly after discontinuation of therapy
  • Less frequent use of ovulation inhibitors (“the pill”) than average women

Environmental exposure – intoxications (poisonings).

  • Occupational contact with carcinogens such as talc (talcum powder) or asbestos.
  • Hair dye

Prevention factors (protective factors)

  • Genetic factors:
    • Genetic risk reduction depending on gene polymorphisms:
      • Genes/SNPs (single nucleotide polymorphism):
        • Gene: XRCC2
        • SNP: rs3814113 in an intergenic region.
          • Allele constellation: CT (0.8-fold).
          • Allele constellation: CC (0.8-fold)
        • SNP: rs3218536 in gene XRCC2
          • Allele constellation: AG (0.8-fold).
          • Allele constellation: AA (0.64-fold)
  • High parity
  • Long periods of lactation (breastfeeding phase): ovarian cancer risk decreases with breastfeeding duration
    • Serous high-grade as well as endometroid ovarian cancer and clear cell carcinoma (-24% lower risk if women had ever breastfed in their lives); borderline tumor -28% lower
  • Combined hormonal contraceptives (CHD; “combined oral contraceptives“, COC; birth control pills) reduce the risk of ovarian cancer.
  • Acetylsalicylic acid (ASA):
    • 75 to 150 mg, continuous > 5 years, resulted in a reduction of epithelial ovarian carcinoma (mucinous carcinoma, endometrioid carcinoma).
    • Population-based study (eight cohort and fifteen case studies): risk reduction of at least.10%.
  • Bilateral salpingo-oophorectomy (bilateral removal of fallopian tubes and ovary): it can reduce the risk of BRCA1 or BRCA2 mutation carriers by 80 to >90%. Timing of prophylactic surgery:
    • BRCA1 mutation: age 35 to 40 years.
    • BRCA2 mutation: age from 40 to 45 years

Note: The cryopreservation of eggs and the associated medical procedures are paid under certain conditions by the statutory health insurance. Excluded are under 18-year-olds and generally women over 40 years.