Does alcohol increases risk?

Evaluating the role of alcohol consumption in breast and ovarian cancer susceptibility using population-based cohort studies and two-sample Mendelian randomization analyses

https://tinyurl.com/j828m3h8

 

         Data previously obtained from the UK Biobank has shown an association with the consumption of alcohol and a increase in the risk of developing breast cancer, with a less clearly demonstrated possibility of increased risk of ovarian cancer also.        

         This retrospective study looked at 69000 women from the Copenhagen general population study, all of who consumed more than 10g of alcohol (about one standard drink) daily. Of these women more than 400 subsequently had ovarian cancer and about 4,000, breast cancer.     

         Hazard ratios for both cancers were obtained with correction for other factors such as obesity and smoking. Drinking alcohol only slightly increases the risk of ovarian cancer. Breast cancer risk increases with consumption of more than two standard drinks daily.

Screening failure

Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

https://tinyurl.com/56vm6t6u

 

         Once again screening for ovarian cancer has proved to be elusive. This trial, the largest ever, commenced in 2001 and recruiting until 2005 had more than 200,000 participants.

         There were three different groups; about 50,000 women were allocated to a regime of measurement of serum CA125; a known marker for ovarian cancer and other disease. The frequency of testing was determined by risk, an algorithm (risk ovarian cancer algorithm ROCA) was used.

         The other two groups were about 50,000 women having annual pelvic ultrasound scans with 100,000 women being in the control group, having no screening. The target for success was decrease in death from ovarian cancer. No difference was seen in the likelihood of death from ovarian cancer for any of the investigation groups. There is still a great need for reliable ovarian cancer screening. 

Dense-dose renaissance

Comparison of dose-dense vs. 3-weekly paclitaxel and carboplatin in the first-line treatment of ovarian cancer in a propensity score-matched cohort

https://tinyurl.com/3srdfe4z

 

         Drug therapy for ovarian cancer is changing fast. New treatment with enzyme inhibitors and immunotherapy is having an effect to improve survival. However, these new therapies are most effective for those few women with ovarian cancer who have an inherited or acquired genetic mutation (about 12% of all cases).

         For most patients the standard therapy for ovarian cancer after surgery is chemotherapy. Since 1992 this therapy has been commonplace and has significantly improved survival. Usually there is a three-week cycle of therapy; dense-dose treatment with a weekly cycle was introduced in 2011.

         Side effects from dense-dose therapy are worse and a trial in Japan looking for benefit (JGOG3016) failed to show any advantage but it remains a preferred therapy option in some countries. This review was of 588 patients in Brazil, of whom 69 patients received dense-dose treatment. These patients had better progress free survival than women who had standard chemo. The authors speculate that non-Asian women are better able to tolerate high treatment doses and show better response.

 

Normal birth weights are good

Birth weight and the risk of histological subtypes of ovarian and endometrial cancers: Results from the Copenhagen School Health Records Register

https://tinyurl.com/3aau66w

 

         Having a normal birth weight is a biological advantage. Low birth weights are associated with prematurity and intra uterine pathology. Greater than normal birth weights may be associated with gestational diabetes and can result in birth trauma.

         For Australian women the current normal range, (within two standard deviations) is a measurement of 2791g at the lower limit and 4176g at the upper end. This study looked at live births in Denmark between 1930 and 1987 (162,559) and compared the birth weights with the risk of future ovarian cancer.

         Findings from the retrospective review showed that both low birth weight and high birth weights were associated with an increased cancer risk. Most of the increased risk was for serous ovarian cancer.