Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1140680 (ovarian cancer)
 28,141 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Whittemore and al. recently published a general paper concerning the risk factors of ovarian cancer, combining the data from 12 epidemiological studies realised from 1979 to 1988. Three of these studies allowed to analyze the role of infertility treatments which were associated to an increased risk (odds ratio = 2.8), specially in nulligravid women (OR = 27.0). However potential bias could not be rejected, and information on drugs was too scanty, so that no definite conclusion could be drawn, even if the results were in accordance with the main physicopathogenical theories. In conclusion, it appears necessary to undertake a large epidemiological study, and, in the same time, even if patients must be reassured, to recommend attention to the doctors when prescribing infertility treatments.
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PMID:[Cancer of the ovary and the treatment of infertility. Analysis of the article by Whittemore et al]. 835 48

Ovarian cancer incidence rates are highest and stable in white populations; in Asia previously low incidence rates may be increasing. Most cases present with disseminated disease, and mortality rates remain high despite the use of aggressive polychemotherapy. Mortality among younger women has decreased, which has been attributed to widespread use of oral contraceptives. Studies consistently show a protective effect of oral contraceptives that increases with duration of use; no dose effect has been identified to date. Risk decreases substantially with increasing numbers of pregnancies; periods of lactation are relatively less protective. Periods of oral contraceptive use are less protective than equal periods of pregnancy. These factors may protect against ovarian cancer due to inhibition of ovulation or due to suppression of another aspect of ovarian function. Hysterectomy and tubal ligation are both protective, perhaps by preventing the ascent of environmental carcinogens that are as yet unidentified. A positive family history substantially increases risk; mutations in the BRCA1 gene may be responsible for about 5% of cases. No other exposures have been consistently associated with disease risk. Whether risk is modified by ovarian damage mediated by dietary galactose is being evaluated; studies to date have conflicting results. The effect of infertility and its treatments on ovarian cancer risk is controversial; two studies suggest that infertility treatments increase risk.
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PMID:Ovarian cancer. 872 17

Ovarian cancer is the second most common cancer of the female reproductive system and the leading cause of death from gynecologic malignancies. In 1995, 26,600 women will be diagnosed with ovarian cancer in the U.S., and 14,500 women will die from the disease. Between 1986-1900, the overall age-adjusted incidence was 14.3/100,000 women; mortality was 7.8/100,000 women. Ovarian cancer, rare before age 40, increases steeply thereafter and peaks at ages 65-75. Incidence and mortality rates are higher among white women than among African-American women. Over the last three decades, ovarian cancer incidence has remained stable in high-risk countries, while an increasing trend has been reported in low-risk countries. Despite recent advancements in treatment, the overall five-year survival rates continues to be low (39%). Over 70% of ovarian tumors are diagnosed when regional or distant involvement has already occurred, causing survival rates to remain stable. The etiology of ovarian cancer is poorly understood. Most studies have focused on the epidemiology of invasive epithelial ovarian tumors, while few have explored the epidemiology of epithelial tumors of low malignant potential and nonepithelial tumors. Factors associated with an increased risk for invasive epithelial ovarian cancer include age, race, nulliparity, family history of ovarian cancer, and history of endometrial or breast cancer. Factors associated with a reduced risk are history of one or more full-term pregnancies, use of oral contraceptives, history of breast feeding, tubal ligation, and hysterectomy. Other factors such as infertility drugs, hormone replacement therapy, age at menarche, age at menopause, dietary factors, lactose intolerance, talc use, coffee and alcohol consumption have been suggested, but their role is still inconclusive.
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PMID:The epidemiology of ovarian cancer. 874 97

Recently, much attention in both the medical and lay communities has been focused on a possible association between fertility drug use and invasive ovarian cancer, and ovarian tumors of low malignant potential. A causal relationship, if shown to exist, has important implications. In the past year, several large case-control and cohort studies have attempted to address this issue. However, interpretation of the available data has been hampered by a number of factors. Retrospective study designs, small numbers of ovarian cancer cases, and inconsistent reporting of fertility drug use and type of infertility have all been common methodological shortcomings. The known ovarian cancer risk factors of low parity and infertility have been particularly difficult to separate from any effect of ovulation induction. The current epidemiologic data are insufficient to implicate conclusively specific fertility medications in ovarian carcinogenesis. The data do suggest that women with refractory infertility may constitute a high-risk population for developing ovarian cancer, independent of fertility drug use. Until the relationship between ovulation induction and ovarian cancer risk is defined more accurately, a high index of clinical suspicion for ovarian neoplasms is indicated before, during, and after treating women for infertility.
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PMID:The risk of ovarian cancer after treatment for infertility. 877 56

The etiology of ovarian cancer is multifactorial. The aim of this literature review is to identify and quantify risk factors from their prevalence, relative risk and the etiological fraction. The most important endogenous risk factors are genetic disposition, parity and infertility. Women who have relatives with ovarian cancer and other adenocarcinomas have relative risks of ovarian cancer of 3 and 1.5 respectively. Nulliparity increases the risk by 100% compared to parous women and infertility implies a further 100-150% increased risk among nulliparae. Use of oral contraceptives in five years decreases the risk by 50% for at least 15 years.
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PMID:[Epidemiology of ovarian cancer]. 884 46

Case reports of ovarian tumors in women undergoing fertility treatment have raised questions about the potential neoplastic effects of ovulation-induction agents used in the treatment of infertility. This has been the subject of much debate, media coverage and patient alarm. An increased risk of malignant epithelial ovarian cancer, borderline epithelial ovarian tumors, and nonepithelial ovarian cancer have been reported in association with the use of fertility drugs. Further review of the literature reveals that there are limitations to the studies reporting this association and indicates that further research is needed before a causal relationship can be established.
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PMID:Ovulation induction for infertility is it safe or not? 897 35

Many couples faced with infertility are treated with ovulation inducing medicines. Recently, concerns have been raised about the possible risk of ovarian malignancy after such ovarian stimulation. Theories of pathogenesis for ovarian cancer include incessant ovulation, elevated pituitary gonadotropins, genetic predisposition, and chemical carcinogens. Protective factors include suppression of ovulation, pregnancy, and castration. Low numbers of exposed women who develop ovarian cancer make this a difficult research subject. Research to date demonstrates conflicting results, with some investigators reporting an increased risk of ovarian cancer with fertility drugs, whereas others do not. The likely magnitude of risk, if one believes a risk exists, may be two to three times that of the general population which is at most 4-5% in a woman's lifetime. The present uncertainty makes it challenging to apply this to today's practice of medicine. With continued efforts worldwide, we hope an understanding of this will be forthcoming.
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PMID:Ovulation induction and ovarian malignancy. 898 31

Ovarian ultrasound is applicable to all ages, from the fetus through childhood and adolescence to the premenopausal and finally postmenopausal women. Indications include the chance finding of an ovarian lesion in the fetus, the diagnosis of ovarian pathology resulting in symptoms and the uses of follicle monitoring in infertility and screening for ovarian cancer in high-risk groups.
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PMID:Ovarian ultrasound. 902 17

Three case reports are used to demonstrate the similarities between the appearances of endometriosis, psammoma bodies, endosalpingiosis and cancer. Although clear "amenorrheic" lesions of endometriosis have been noted since 1950 by Fallon, these have been confused in clinical practice with a similar appearance of psammoma bodies, endosalpingiosis and ovarian cancer. The difference between these must be made on the basis of histology and appearance. Furthermore, the presence of psammoma bodies in an infertility population is more compatible with post-inflammatory changes from chlamydia than with cancer. The diagnosis of cancer is based on epithelium and not the appearance of calcification.
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PMID:Clear and Opaque Vesicles: Endometriosis, Psammoma Bodies, Endosalpingiosis or Cancer? 907 13

Due to previously reported associations of ovarian cancer with pelvic inflammatory disease, tubal infertility, and positive Chlamydia trachomatis titers, women undergoing follow-up for ovarian cancer were screened with a C. trachomatis IgG titer. Positive titers were seen in 15 (79%) of 19 women with ovarian cancer, 9 (90%) of 10 age-matched controls, and 14 (67%) of 21 patients with infertility and pain. When analyzed by age, 4 (40%) of 10 women under 30 years of age and 34 (85%) of 40, 30 years of age or older had positive titers (p = 0.007). Of 21 women with positive Chlamydia pneumoniae titers, 17 (81%) had positive C. trachomatis titers, whereas 17 (85%) of 20 with positive C. trachomatis titers had positive C. pneumoniae titers. The high rate of positive C. trachomatis titers in older women may be due to cross-reaction with C. pneumoniae titers. Although C. trachomatis IgG titers may be useful as an immunologic screening marker in infertile women, the results of these tests should be interpreted with caution. A positive test may not be evidence of C. trachomatis infection and is not an indication for specific therapy.
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PMID:Association of Positive Chlamydia trachomatis and Chlamydia pneumoniae Immunoglobulin G Titers with Increasing Age 907 48


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