Epidemiology of ovarian cancer: a review

(整期优先)网络出版时间:2017-01-11
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Ovariancancer(OC)istheseventhmostcommonlydiagnosedcanceramongwomenintheworldandthetenthmostcommoninChina.EpithelialOCisthemostpredominantpathologicsubtype,withfivemajorhistotypesthatdifferinorigination,pathogenesis,molecularalterations,riskfactors,andprognosis.Geneticsusceptibilityismanifestedbyrareinheritedmutationswithhightomoderatepenetrance.Genome-wideassociationstudieshaveadditionallyidentified29commonsusceptibilityallelesforOC,including14subtype-specificalleles.Severalreproductiveandhormonalfactorsmaylowerrisk,includingparity,oralcontraceptiveuse,andlactation,whileotherssuchasolderageatmenopauseandhormonereplacementtherapyconferincreasedrisks.Theseassociationsdifferbyhistotype,especiallyformucinousOC,likelyreflectingdifferencesinetiology.EndometrioidandclearcellOCshareasimilar,uniquepatternofassociationswithincreasedrisksamongwomenwithendometriosisanddecreasedrisksassociatedwithtuballigation.OCrisksassociatedwithothergynecologicalconditionsandprocedures,suchashysterectomy,pelvicinflammatorydisease,andpolycysticovariansyndrome,arelessclear.Otherpossibleriskfactorsincludeenvironmentalandlifestylefactorssuchasasbestosandtalcpowderexposures,andcigarettesmoking.Theepidemiologyprovidescluesonetiology,primaryprevention,earlydetection,andpossiblyeventherapeuticstrategies.