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Query: UMLS:C1140680 (ovarian cancer)
 28,141 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Data collected from 2,197 white ovarian cancer patients and 8,893 white controls in 12 US case-control studies conducted in the period 1956-1986 were used to evaluate the relation of invasive epithelial ovarian cancer to reproductive and menstrual characteristics, exogenous estrogen use, and prior pelvic surgeries. Clear trends of decreasing risk were evident with increasing number of pregnancies (regardless of outcome) and increasing duration of breast feeding and oral contraceptive use. Ovarian dysfunction leading to both infertility and malignancy is an unlikely explanation for these trends for several reasons: 1) The trends were evident even among the highly parous; 2) risk among nulliparous women did not vary by marital status or gravidity; and 3) risk among ever-married women showed little relation to length of longest pregnancy attempt or history of clinically diagnosed infertility. Risk was increased among women who had used fertility drugs and among women with long total duration of premenopausal sexual activity without birth control; these associations were particularly strong among the nulligravid. No consistent trends in risk were seen with age at menarche, age at menopause, or duration of estrogen replacement therapy. A history of tubal ligation or of hysterectomy with ovarian conservation was associated with reduced ovarian cancer risk. These observations suggest that pregnancy, breast feeding, and oral contraceptive use induce biological changes that protect against ovarian malignancy, that, at most, a small fraction of the excess ovarian cancer risk among nulliparous women is due to infertility, and that any increased risk associated with infertility may be due to the use of fertility drugs.
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PMID:Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Collaborative Ovarian Cancer Group. 848 84

Epithelial ovarian neoplasms of low malignant potential, also called borderline ovarian tumors, have various features of malignancy, but they do not invade the ovarian stroma. Women with these tumors usually are younger when diagnosed and have better prognoses than do women with invasive tumors. There have been few epidemiologic studies of borderline tumors, and it is unclear whether there are etiologic differences between the two types of tumor behavior. Combined data from nine case-control studies, conducted from 1974 to 1986 and representing 327 white women with tumors of low malignant potential and 4,144 white controls, were used to evaluate the relation between these tumors and personal characteristics related to invasive ovarian cancer. The risk profile for tumors of low malignant potential was found to be similar to that for invasive tumors, with two exceptions: Compared with that of invasive tumors, risk of borderline tumors was less clearly reduced among women who had used oral contraceptives and more clearly elevated among women with a history of infertility.
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PMID:Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. III. Epithelial tumors of low malignant potential in white women. Collaborative Ovarian Cancer Group. 147 42

The addition of pulsed and color Doppler has greatly added to the diagnostic potential for obstetric and gynecologic ultrasound. In addition to improved morphologic detail inherent in the use of EVUS, new information is available on perfusion and the physiologic changes associated with the menstrual cycle and early pregnancy. The absence of luteal flow strongly predicts unsuccessful pregnancy outcome in patients undergoing therapy for infertility. This introduces the possibility of more economic use of expensive treatments. Later in pregnancy, DCI aids in the efficient and accurate performance of Doppler spectral sampling and contributes to the evaluation of structural and functional abnormalities of the fetus, umbilical cord, and placenta. Applications in the evaluation of patients with suspected ectopic pregnancy, incomplete abortion, and pseudosac are welcome additions for clinical problems that currently result in many malpractice suits. Finally, the recognition of neovascular flow, especially in the ovary, raises hope for improved and earlier diagnosis of ovarian cancer.
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PMID:Doppler color imaging. Obstetric and gynecologic applications. 149 38

Transvaginal ultrasonography is routinely performed in the course of egg retrieval in patients presenting for in vitro fertilization (IVF) and results in the discovery of occult, subclinical ovarian cysts that would otherwise have gone undetected. This study (1) evaluated the cellular composition of the cyst fluids based on a comparison with cells obtained from cysts of known and documented histologic type, and (2) attempted to determine if the cytologic evaluation of cyst fluid was necessary to exclude occult ovarian cancer. During the 1.8 years of our study, 931 patients underwent 1,544 ultrasound-guided ovum retrievals; during this same period, 90 specimens of ovarian cyst fluid were examined. Of them, none contained cancer cells. A single case of cystic ovarian cancer was detected by ultrasound but was not aspirated. The cytologic diagnosis of endometriosis was established in 12 specimens from 10 patients, 5 of whom did not have a previously documented clinical diagnosis of endometriosis. The role of routine ovarian cyst fluid cytology as part of an IVF protocol may be of limited value in cancer diagnosis. However, until the incidence of ovarian cancer in the subset of women with both infertility and ovarian cysts is known, it would seem prudent to continue to examine any voluminous or discolored ovarian cyst fluid obtained from IVF patients. The presence of ovarian cysts did not affect the clinical pregnancy rate per retrieval.
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PMID:Aspiration cytology of ovarian cysts in in vitro fertilization patients. 154 6

TVS has brought the pelvic organs closer to us than ever before. Color Doppler probes have exposed small vessels that could not be seen with real-time technique alone, and pulsed Doppler is becoming an important adjunct in many physiologic and pathologic states. Vascular changes of the ovary and uterus during the menstrual cycle are now being followed during infertility protocols, are being investigated to determine the viability of an early pregnancy, and may increase our confidence in the diagnosis of an ectopic pregnancy in a few selected cases. Waveform analysis may be useful in discriminating benign from malignant uterine masses, and additional work in the diagnosis of pelvic thrombophlebitis and ovarian torsion is anticipated. Color Doppler sonography has an important role to play in the diagnosis of early ovarian cancer. A large multicenter trial is ongoing in this country to determine if there is a characteristic PI that will determine whether an adnexal mass is benign. While much of this work is preliminary, TV-CDS has tremendous potential in the assessment of pelvic disease.
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PMID:Doppler ultrasonography of the pelvis. 163 Dec 80

Relationships between ovarian cancer and ability to conceive were explored in a case-control study of 188 women with histologically confirmed epithelial ovarian cancer and 539 control women in the San Francisco Bay Area. Control women consisted of two groups: those hospitalized without cancer, matched to cases by age, race, and hospital of diagnosis (n = 280); and those selected from the general population by random digital dialing, matched to cases by age, race, and telephone prefix (n = 259). Ovarian cancer risk among nulliparous (but not parous) women was positively associated with a history of unsuccessful attempts to conceive, of physician-diagnosed infertility, and of doubts about ability to conceive. Among all women, risk increased with increasing years of unprotected intercourse (P value for trend = 0.02). Risk among women having 10 or more yr of unprotected intercourse was 1.8 relative to that among women having less than 2 such yr (P = 0.01). This association was independent of parity, oral contraceptive use, and estimated years of ovulation, each associated with ovarian cancer. Further, duration of unprotected intercourse combined multiplicatively with each of these latter characteristics in increasing ovarian cancer risk. For example, while cancer risk exhibited a 2-fold range from lowest to highest years of unprotected intercourse and a 4-fold range from lowest to highest years of ovulation, risk among women in the highest joint category of these characteristics was 8 times that of women in the lowest category. We believe that some abnormality of ovulation that reduces the likelihood of conception plays a role in epithelial ovarian cancer.
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PMID:Epithelial ovarian cancer and the ability to conceive. 273 45

We found the prevalence of ovarian cancer in infertile women less than 40 years at the time of planned microsurgery for infertility to be 1 in 95. This may represent a greater prevalence of ovarian cancer than that of all women less than 40 years. Importantly, laparoscopy did not find the ovarian cancer in these women. In conclusion, laparoscopists and microsurgeons need to be aware of the possibility of finding ovarian cancer in these young, infertile women, and this knowledge should be used to counsel and manage the patient appropriately.
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PMID:Prevalence of ovarian cancer found at the time of infertility microsurgery. 334 10

Data from the Cancer and Steroid Hormone study was used to evaluate the effect o cigarette smoking on the risk of developing epithelial ovarian cancer. This multicenter, population-based case-control study of oral contraceptive (OC) use and ovarian, breast, and endometrial cancer enrolled women between December 1, 1980, and December 31, 1982, in 8 geographic areas: Atlanta, Detroit, San Francisco, and Seattle; the states of Connecticut, Iowa, and New Mexico; and the 4 urban counties of Utah. Eligible cases were women 20-54 years old first diagnosed as having ovarian cancer of any histologic type which was ascertained through population-based tumor registries in the above-mentioned areas during the study interval. Interviews were completed with 579 of the eligible cases (71.0%). The study controls were women 20-54 years of age selected by telephoning randomly selected phone numbers of households in the same geographic areas as the cases. 4754 of those selected were interviewed. A standard questionnaire was administered to participants in their homes by trained interviewers. Women who had never smoked a total of 100 cigarettes to be nonsmokers in this analysis. Age, parity, and ever-use of OCs (for 3 or more consecutive months) were considered to be potentially confounding factors because they are known to be associated with smoking. Women with epithelial ovarian cancer were more likely than controls to be white, nulliparous, to have used OCs, and to have had a natural menopause. Women who had ever smoked cigarettes had the same risk of epithelial ovarian cancer as women who had never smoked; this was the case when current smoking and past smoking were considered. There was a slightly reduced risk of ovarian cancer among women who had stopped smoking 10 or more years earlier, but the association was not statistically significant. Cumulative lifetime exposure to cigarette smoking categorized by increasing pack-years showed no statistically significant dose effect. Among smokers, no significant linear trend was present when pack-years was used as a continuous variable. No effect of latency was found. The age that a woman began smoking had no effect on ovarian cancer risk. Stratification of the data according to age, race, education, parity, OC use, infertility, noncontraceptive estrogen use, menopausal status, alcohol use, obesity, and family history of ovarian cancer did not reveal any appreciably different effects of smoking on ovarian cancer risk in different subgroups of women. Likelihood ratio tests revealed no statistically significant interactions.
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PMID:Cigarette smoking and the risk of epithelial ovarian cancer. 359 76

The new generation of oral contraceptives (OCs) contains less than 50 mcg of estrogen compared to previous levels of 100-150 mcg, and as a result have fewer undesirable side effects. In addition, it appears that the newer OCs decrease the susceptibility to many diseases. For example, the pill decreases by 40% the risk that a woman under 55 years of age will develop ovarian cancer. The risk of endometrial cancer is reduced by 50% in OC users. The pill also significantly lowers the risk of pelvic inflammatory disease--a condition that is involved in almost 20% of all gynecologic problems and is a leading cause of infertility. OC use reduces the risk of ectopic pregnancy. Further, by decreasing menstrual blood flow, the pill protects against iron-deficiency anemia. The pill is claimed to decrease premenstrual tension, menstrual cramps, and even acne. It has a protective effect against ovarian cysts and benign breast cancer. Finally, there is the possibility that OCs protect against the development of rheumatoid arthritis and duodenal ulcers.
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PMID:Oral contraceptives come of age. 385 23

Since oral contraceptives have been used by more than 40 million American women, an association between oral contraceptives and ovarian cancer could have a substantial public health impact. The Centers for Disease Control, Atlanta, is studying this relationship as part of a multicenter, case-control study--the Cancer and Steroid Hormone Study. During the first ten months of the study, we enrolled 179 women aged 20 to 54 years who had been ascertained to have newly diagnosed ovarian cancer by eight population-based cancer registries. From the general population of those eight areas, we selected as controls 1,642 women with intact ovaries. Users of oral contraceptives had an age-adjusted risk of ovarian cancer developing of 0.6 relative to those who had never used them (95% confidence interval, 0.4 to 0.9). The risk of ovarian cancer decreased with increasing duration of oral contraceptive use and remained low long after cessation of use. These results were not accounted for by parity, infertility, or other potentially confounding factors. We estimate that more than 1,700 cases of ovarian cancer are averted each year by past and current oral contraceptive use among women in the United States.
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PMID:Oral contraceptive use and the risk of ovarian cancer. The Centers for Disease Control Cancer and Steroid Hormone Study. 633 64


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