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

Forty women who had undergone previous abdominal surgical procedures were evaluated by open laparoscopy with a simple technique that required no special instrumentation. Gynecologic problems included infertility, suspected endometriosis and/or pelvic adhesions, ovarian cysts, and second-look laparoscopy after treatment for ovarian cancer. The technique was evaluated in regard to ease of performance in patients with various abdominal incisions. Conventional instrumentation was used. No significant side effects were experienced and anesthesia time was prolonged by no more than 10 to 20 minutes in most cases. Significant subincisional adhesions were found in 35% of patients. It is suggested that open laparoscopy in patients who have had previous abdominal surgery deserves reevaluation.
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PMID:Open laparoscopy with conventional instrumentation. 645 Sep 7

A population-based case control study was conducted with 403 white, ovarian cancer patients, ages 20-79, who were diagnosed from October 1977-February 1980 in 11 New York State counties. The study also included 806 controls who were matched to the cases by age, race, and county of residence. The contraceptive and reproductive patterns observed in this study suggest that infertility plays an important role in determining the relationship between reduced parity and gravidity and increased ovarian cancer risk. Ovarian cancer patients were less likely than controls to have ever used nonpermanent birth control methods (relative risk=0,63, 95% confidence interval=0.45-0.89), and they tended to practice contraception less often. A direct graded response relationship was observed between ovarian cancer risk and the number of contraceptive-free years of marriage (chi square linear trend=5.911, p=0.02). An inverse graded response relationship was observed between gravidity and risk. This relationship persisted even after contraception was taken into account (chi square linear trend=13.002, p=0.0003). Ovarian cancer risk was not found to be associated with an excess in reported fetal loss.
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PMID:An epidemiologic case-control study of ovarian cancer and reproductive factors. 653 67

The effect of smoking on the development of breast, endometrial, and ovarian cancers is evaluated among cases identified between November 1980 and July 1982 in the Iowa Surveillance, Epidemiology, and End Results Cancer Registry. Population-based, age-frequency matched controls were also evaluated, adjusting for potential confounders: Age, age of menarche, age of menopause, duration of menses, female family reproductive cancer history, obesity, parity, infertility, and lifetime steroid hormone use. Logistic regression analyses of total pack-years of cigarette exposure indicate that smoking is not significantly related to the development of breast cancer [relative risk (RR) = .99; confidence interval (CI) = .97, 1.02] or ovarian cancer (RR = 1.00; CI = 1.00, 1.00). Among women with endometrial cancer, the risk for those who smoke is increased among premenopausal women (RR = 1.27; CI = .65, 2.59) and decreased among postmenopausal women (RR = .41; CI = .16, 1.04).
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PMID:Effects of smoking on the development of female reproductive cancers. 658 29

The relation between the use of combination oral contraceptives (OCs) and the risk of epithelial ovarian cancer was investigated in a case-control study conducted in Milan on 209 women below the age of 60 with histologically confirmed epithelial ovarian cancer, and 418 age-matched controls with a spectrum of acute conditions apparently unrelated to OC use. Combination oral contraceptives were used by 18 (9%) cases, and 59 (14%) controls, giving a relative risk estimate of 0.6 (95% confidence interval = 0.3-1.0, P less than 0.05). The risk of ovarian cancer decreased with increasing duration of use and the point estimate remained below unity long after cessation of use. These results were not accounted for by parity, infertility, or other identified potential confounding factors. Thus, the findings of the present study add further support to the evidence emerging from American data of a reduction of approximately 40% in the risk of epithelial ovarian cancer among women who had used oral contraceptives.
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PMID:Oral contraceptive use and the risk of epithelial ovarian cancer. 674 13

A review of prospective and retrospective epidemiologic studies of oral contraceptives (OCs) shows that in addition to pregnancy prevention, OCs provide other health benefits resulting from the antiestrogenic action of the progestin in the pills and from its main action, inhibition of ovulation. The antiestrogenic effects include reduction of risk of iron deficiency anemia by about 50% because of reduced menstrual blood loss. The Royal College of General Practitioners (RCGP) study reports that OCs protect about 7 of 1000 pill users/year from iron deficiency anemia, and that OC use significantly reduces the incidence of menstrual disorders (menorrhagia, irregular menses, intermenstrual bleeding). Other studies report elimination of endometrial hyperplasia (Sturdee et al.), 50% reduction in risk of endometrial cancer (Weiss and Sayvetz, Boston University Epidemiologic Survey), and reduction in incidence of benign breast diseases (at least 12 published studies). The noncontraceptive benefits resulting from inhibition of ovulation include significant reduction in the incidences of dysmenorrhea (RCGP study), functional ovarian cysts (RCGP study, Boston Collaborative Surveillance Program, Ory), and ovarian cancer (Beral et al., Casagrande et al.) OCs are also found to protect against rheumatoid arthritis (RCGP, Rochester Epidemiologic Project), and salpingitis or pelvic inflammatory disease (PID). 6 epidemiologic studies show that the relative risk of developing PID among pill users compared with nonusers ranges from 0.3 - 0.9. Increased OC use by the population at greatest risk--sexually active women between 15-24 years old--would significantly reduce PID with its high cost of treatment and resulting infertility. It is hoped that healthy young women will realize that OCs provide benefits (including prevention of unwanted pregnancy) that far outweigh their more widely publicized, infrequent risks.
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PMID:Noncontraceptive health benefits of oral steroidal contraceptives. 706 59

Results of a case-control study of histologically verified ovarian cancer including details about oral contraceptive (OC) use are presented. 144 white Massachusetts residents under age 60 with primary epithelial ovarian cancer were matched with 139 control women randomly selected from lists of Massachusetts residents who matched the cases by residence, age within 2 years, and race. Twice as many cases as controls were single and nulliparous. 34 cases had at some time used OCs compared with 48 controls. The relative risk of ovarian cancer associated with OC use, standardized for age and parity, was .38 with 95% confidence limits of .15 to .96. A decreased risk associated with OC use in subjects 40-59 years at the time of the study was observed; the relative risk, adjusted for parity, was .11, with 95% confidence limits of .04 to .33. A decreased risk associated with OC use was not found in women under 40, whose adjusted relateive risk associated with OC use was 1.98, with 95% confidence limits of .74 to 5.27. No significant differences were observed between parous and nonparous subjects. Differences in histological characteristics of cancer in OC users and nonusers were not significant, but a larger study might have uncovered differences. The lowest risk for ovarian cancer associated with the use of OCs was observed in older parous subjects and in women who had discontinued use more than 10 years previously. Potential biases that should be considered in this study include the high refusal rate among controls and the possibility that underlying infertility might confound any association of OCs and ovarian cancer.
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PMID:Factors affecting the association of oral contraceptives and ovarian cancer. 712 14

Among a large cohort of married, female, registered nurses under 55 years of age, oral contraceptive (OC) use was examined in women with ovarian cancer and 470 age-matched controls. Use of OCs before the diagnosis of cancer was reported by 28% of the women with ovarian cancer and 33% of the controls, yielding a relative risk of 0.8 (95% confidence limits 0.4-1.5). This apparent inverse relationship was attributable to a large effect in women 35 years of age or younger (relative risk = 0.2, 95% confidence limits 0.1-1.0). Patients with ovarian cancer were 2.2 times more likely than controls to be nulliparous. These data provide reassurance that OC use is not likely to be associated with any major increase in risk of ovarian cancer, but suggest that future studies of this relationship need to consider the possible confounding effect of infertility.
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PMID:Oral contraceptives and risk of ovarian cancer. 728 69

Concern has been expressed that exposure to fertility drugs might be associated with a risk of ovarian cancer. We have examined the incidence of breast and ovarian cancer in a cohort of 10,358 women referred for in-vitro fertilisation (IVF) treatment in Victoria, Australia, between 1978 and 1992. The "exposed" group (n = 5564) had had ovarian stimulation to induce multiple folliculogenesis and the "unexposed" group (n = 4794) had been referred for IVF but were untreated or had had "natural cycle" treatment without ovarian stimulation. Duration of follow-up ranged from 1 to 15 years. Cases of cancer were determined by record linkage with data from population-based cancer registries. 34 cases of invasive breast cancer and 6 of invasive ovarian cancer were observed. A comparison with the expected numbers, derived by applying age-standardised general population rates to the cohort gave standardised incidence ratios (SIR) for breast cancer of 0.89 (95% CI 0.55-1.46) in the exposed group and 0.98 (0.62-1.56) in the unexposed group, and for ovarian cancer SIRs were 1.70 (0.55-5.27) and 1.62 (0.52-5.02), respectively. Rates of all cancers were not significantly different from general population rates. The relative risk (RR) of cancer, adjusted for age and infertility type, was, in the treated group compared with the untreated group, 1.11 (95% CI 0.56-2.20) for breast cancer and 1.45 (0.28-7.55) for ovarian cancer. The risk of body of uterus cancer was increased in the exposed and unexposed groups combined (SIR 2.84 [1.18-6.81]). Women with unexplained infertility, independent of IVF exposure, had significantly increased risks of ovarian cancer (RR = 19.19 [2.23-165.0]) and body of uterus cancer (RR = 6.34 [1.06-38.0]) compared with women with known causes of infertility. This relatively short-term follow-up suggests that ovarian stimulation with IVF is not associated with an increased risk of breast cancer. Although there was no significantly increased risk of ovarian cancer after ovarian stimulation with IVF the small number of cases limits the conclusions that can be drawn. Longer-term follow-up of large cohorts of women who have been in IVF programmes will be necessary.
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PMID:Breast and ovarian cancer incidence after infertility and in vitro fertilisation. 750 Jul 68

Ascites is a rare but important complication of endometriosis because it mimics ovarian cancer. Most cases occur in nulliparous young black women and present with massive ascites. Treatment is effected by ablation of ovarian function by surgery, radiotherapy, or suppression of endometriosis by endocrine therapy. The pathogenesis is unknown. In this paper, we present a case report and review of the other 19 cases in the literature. Because of the age of most of these women, endocrine therapy is preferred rather than castration. The majority of symptoms and signs of endometriosis are well known, including pelvic pain, dysmenorrhea, dyspareunia, infertility, and pelvic tenderness with or without masses. However, it is seldom appreciated that the disease can be a cause of, and can present with ascites, often massive and recurrent. It is important for gynecologists and oncologists to be aware of this entity because the presence of ascites with abdominal and/or pelvic masses and weight loss immediately suggests the diagnosis of malignancy, and the possibility of endometriosis is rarely considered. We are reporting a case of endometriosis causing massive and recurrent ascites, along with a review of the literature and a discussion of the epidemiology, pathogenesis, and management of this disorder.
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PMID:Ascites due to endometriosis. 747 17

Infertility is a common complication of pelvic inflammatory disease (PID) and may result in decreased parity. Low parity and possibly infertility are risk factors for ovarian cancer. We therefore examined the association between ovarian cancer and history of PID in a case-control study conducted during 1989-1992 in metropolitan Toronto and nearby areas of Southern Ontario, Canada. In total, 450 histologically verified new primary epithelial ovarian cancer cases ages 35-79 years were interviewed concerning their reproduction history. Over the same period, 564 randomly selected population controls, frequently matched to the cases according to three 15-year age groups, were interviewed similarly. Continuous unconditional logistic regression methods were used for analysis. It was found that cases were more likely than controls to report having had one or more episodes of PID; adjusted for age, parity, duration of oral contraceptive use, and other factors the odds ratio (OR) was 1.53 [95% confidence interval (CI), 1.10-2.13; P = 0.012]. Higher risk was present for women with recurrent PID (OR, 1.88; 95% CI, 1.13-3.12; P = 0.014). The elevated risk associated with PID was seen particularly among women < 60 years of age at interview (OR, 1.60; 95% CI, 1.09-2.35; P = 0.016), for women of parity 0 or 1 (OR, 2.40; 95% CI, 1.39-4.15; P = 0.0017), among women who had never ever had infertility (OR, 3.74; 95% CI, 1.28-10.9; P = 0.016), and for the small number of women who reported having PID before age 20 (OR, 3.08; 95% CI, 1.17-8.13; P = 0.023).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pelvic inflammatory disease and the risk of epithelial ovarian cancer. 754 98


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