Ovarian Cancer Overview
The ovaries are the part of the female reproductive system where eggs are produced. Ovarian cancer starts in ovarian tissue cells. It may also originate in the far (distal) end of a fallopian tube.
The ovaries contain three main types of cells. Cancer can start to grow in any cell type. The cell where cancer originates determines the type of tumor you have:
Epithelial tumors start in cells on the surface of the ovary. Ninety percent of ovarian tumors are epithelial tumors. Malignant germ cell tumors start in egg cells. Stromal tumors start in structural tissue cells.
How Common is Ovarian Cancer?
One out of every 78 females in the United States will get ovarian cancer during their lifetime. This number may sound high, but the annual rate for ovarian cancer has steadily declined since 1999.
As the American population continues to age, more and more people are entering age groups that have increased cancer risk. Even so, the Centers for Disease Control and Prevention (CDC) projects that ovarian cancer rates will continue to drop over the next several decades.
Ovarian Cancer by Ethnicity
Ovarian cancer rates vary by ethnicity, although the reasons for this are not completely clear. Non-Hispanic White women have the highest rate of diagnosis of this disease, followed in order by Hispanic, Asian/Pacific Islander, and non-Hispanic Black women.
Ovarian Cancer by Age
Ovarian cancer is rare in people under 40. The risk for this cancer increases after menopause.
Around 50% of all ovarian cancers are found in people 63 and over. The reasons for this are not completely understood, but it is thought that lifetime exposure to estrogen (a sex hormone produced by the ovaries) may play a role.
Data compiled from 2018 by the American Cancer Society and National Center for Health Statistics indicates ovarian cancer risk by age for U.S. women as follows:
Risk factors for ovarian cancer include:
Being 63 or older Being overweight Never carrying a pregnancy to term Having your first full-term pregnancy after 35 Taking estrogen, with or without progesterone, after menopause Family history of ovarian, breast, or colorectal cancer on the maternal or paternal side Having a family cancer syndrome History of breast cancer
What Are the Mortality Rates for Ovarian Cancer?
Based on data accrued from 2012 to 2018, the estimated five-year survival rate for ovarian cancer is 49.7%.
Since five-year survival statistics are at least five years old by definition, this statistic does not take into account new treatments, such as novel cancer immunotherapy combinations or current clinical trials. These and other treatments may have the potential to positively impact survival rates over time.
The amount of spread (metastasis) and type of tumor you have can affect the estimated survival rate. Localized cancers have the highest estimated survival rates and distant tumors have the lowest. Based on data compiled from 2011 to 2017, the five-year estimated survival rates for ovarian cancer by tumor type are:
Invasive epithelial ovarian cancer:
Localized: 93%Regional: 75%Distant: 31%
Ovarian stromal tumors:
Localized: 97%Regional: 90%Distant: 70%
Ovarian germ cell tumors:
Localized: 98%Regional: 94%Distant: 74%
The risk of death from this disease increases with age. Ovarian cancer deaths are highest among people 65 to 74.
The mortality rate by race/ethnicity per 100,000 people for this condition is:
Non-Hispanic White: 6. 9%Non-Hispanic American Indian/Alaska Native: 6. 6%Non-Hispanic Black: 5. 9%Non-Hispanic Asian/Pacific Islander: 4. 4%Hispanic: 5. 0%
Screening and Early Detection
Early-stage ovarian cancer is often asymptomatic (causes no symptoms). Early symptoms, such as frequent urination, pelvic pain, or bloating, may go unnoticed or be mistaken for other conditions.
Survival rates don’t include current data or trends. If you are newly diagnosed, remember that survival rates for ovarian cancer continue to improve every year.
There is also no specific screening test for ovarian cancer. For these reasons, only around 20% of malignant ovarian tumors are found early. Early diagnosis can make a difference in survival rates. Around 94% of people who get diagnosed early are alive five years later.
See a healthcare provider if you have ongoing or persistent symptoms that may indicate this disease. Early treatment may prevent the spread and lead to a positive outcome.
A healthcare provider will use these tests to make a preliminary diagnosis:
Complete pelvic exam: Manual pelvic exams assess the size, shape, and consistency of the ovaries and uterus. It may alert your healthcare provider to anomalies but it won’t find every tumor. Transvaginal ultrasound: This test uses sound waves to find tumors but can’t be used to determine if the tumor is malignant (cancerous) or benign (noncancerous). CA-125 blood test: This test measures the amount of CA-125 protein in the blood. Ovarian cancer, endometriosis, and pelvic inflammatory disease may all raise CA-125 blood levels. This blood test may provide some information but is not considered particularly useful for diagnosing ovarian cancer. Computed tomography (CT) scan: Imaging tests may be used if your healthcare provider suspects ovarian cancer. CT scans don’t show small ovarian tumors and may not be beneficial for finding early cancers. However, they can locate large tumors, enlarged lymph nodes, and ovarian cancer that has spread to other parts of the body. Biopsy: A biopsy will be needed to make a definitive diagnosis. For ovarian cancer, the tumor will be removed surgically and analyzed in a laboratory to look for malignant cells.
If metastasis is suspected, you may have several additional tests that look for cancer spread into specific locations:
Colonoscopy to check the colon or rectum via a flexible tube with a camera inserted through the anus Magnetic resonance imaging (MRI) to check the brain or spinal cord using powerful magnetic fields Chest X-ray to check the lungs
Summary
One in 78 women will be diagnosed with ovarian cancer during their lifetime. Rates for the incidence of this disease have decreased and are expected to continue to decline over time. Early-stage ovarian cancer can be asymptomatic, or present with common symptoms that may indicate several conditions.
The best way to improve overall survival from this disease is early detection. Since there is no screening test for ovarian cancer, it’s important to let a healthcare provider know about any changes or symptoms you have, even if they are mild. Regular gynecological checkups may also help.
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