Risk of ovulation

Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis

https://tinyurl.com/hk687y9f

         For many years the incidence of epithelial ovarian cancer (EOC) has been decreasing, it is thought that a major contributing factor has been the suppression of ovulation with the use of hormonal contraception. Breast-feeding, which similarly suppresses ovulation, is also protective.

         This meta-analysis looks at a large number of cases and controls and measures the number of lifetime ovulatory years and compares the risk of developing EOC.

         Results from the survey show that risk of developing all types of ovarian cancer, other than mucinous tumours, increased with the number of ovulatory years. Further analysis of the data indicated that other unknown factors, apart from the number of ovulatory cycles, are important in the adverse effect.

Microbiome change

Diagnostic and prognostic potential of the microbiome in ovarian cancer treatment response

https://tinyurl.com/2p95fw7a

         There are many causes of ovarian cancer, some environmental. Changes to the microbiome have been thought to be a contributing factor. 

         This small study looks at the microbiome of the vagina, cervix, uterus, tubes and ovaries together with samples from the peritoneum. Data was collected from 30 women known to have ovarian cancer and 34 other women having surgery for benign conditions.

         The usual microbiome is mostly composed of lactobacillus. For those women with ovarian cancer the microbiome was much more diverse with less predominance of lactobacillus. It is unknown whether this is a cause or effect. However, the authors suggest that changes in the microbiome could be a predictor for ovarian cancer and also response to treatment.

ctDNA

Identification of TP53 mutations in circulating tumour DNA in high grade serous ovarian carcinoma using next generation sequencing technologies

https://tinyurl.com/ykn95w8y

 

         Ovarian cancer frequently recurs and early treatment of recurrence improves survival. Currently the progress of ovarian cancer is monitored by serial measurement of serum CA125, a cancer antigen. 

         There are problems with this approach; CA125 has a long half-life so there may be a lag in detecting change. Also, the CA125 measurement does not relate to tumour size, which is an important indicator of survival impact.

         For other cancers such as prostate and colon, circulating tumour DNA (ctDNA) is used to determine residual or recurrent tumour size; ctDNA is present as a result of cancer cell disruption.

         Identification of ctDNA from ovarian cancer depends on a genetic marker; ovarian cancer often carries the TP53 mutation. This small prospective study showed ctDNA in 10 patients with active ovarian cancer all of whom carried the TP53 genetic mutation, suggesting this may be a better means of surveillance.

Changing trends

Trends of Ovarian Cancer Incidence by Histotype and Race/Ethnicity in the United States 1992–2019

https://tinyurl.com/4sk2aybpè

 

         There is no doubt that ovarian cancer is changing, with different types becoming more prevalent and altered ethnic distribution.

         This retrospective survey took information from the US SEER-12 program over the period 1992-2019 looking at the trend in ovarian cancer incidence in four ethnic groups; Asian, Hispanic, Non-Hispanic black, and Non-Hispanic white.

         Although high-grade serous ovarian cancer remains the commonest, there has been a significant decrease in the incidence, of 6%, mostly in the white community. Clear cell cancer has increased especially in Asians but also across the board.