The risk of contracting ovarian cancer appears to be higher in women with cancer of the uterus, says a new study from UCLA.1 The team of researchers, both from UCLA and Cedars-Sinai Medical Center in Los Angeles, found that the risk of ovarian cancer is 25% higher in women with endometrial cancer.
Risk Assessment
While a conservative treatment approach is often advocated for young, premenopausal women in the clinical setting as a way to preserve fertility, "there are also reports of a higher incidence of ovarian malignancy" in these women, wrote Ilana Cass, MD, in the division of Gynecologic Oncology at Cedars-Sinai Medical Center, and her colleagues.
If these women actually do face a higher risk of ovarian cancer, there would be "important implications" in terms of not only treating, but counseling these women, they wrote. Thus, Cass and her colleagues set out to determine the risk of this type of cancer in those diagnosed with uterine cancer.
Database Search
Using several medical databases, the physicians researched patient information collected between 1996 and 2004. All patients under age 45 who had been diagnosed with endometrial cancer and treated with hysterectomy during the study period were identified. They then searched for those who had been diagnosed with uterine cancer, and later diagnosed with cancer of the ovary, as well as indicators that could help them understand who among those with uterine cancer may be at higher risk of developing ovarian cancer.
The researchers also collected information on each patient's age, body mass index (a measure of a person's healthy weight corresponding to his or her height), medical and family histories, reproductive history, surgical information, and use of treatment besides hysterectomy.
Histories of Ovarian Cancer Diagnosis
Cass and her team identified more than 100 women from the database who had undergone hysterectomy for endometrial cancer. A major percentage of the patients had some reproductive health problem, such as infertility, polycystic ovary syndrome (PCOS), or irregular periods. Before hysterectomy, a quarter of the patients had been treated with hormone therapy for up to 18 months, and an additional 16 percent of the women had wanted to preserve their ovaries.
Based on the patient data, Cass' group learned that 25 percent of the women had been diagnosed with coexisting ovarian cancer; most had been discovered when their hysterectomies had been performed. Preoperative imaging, such as x-rays, are too insensitive to detect ovarian cancer, and as such, is "of limited value", the research team noted.
Of those diagnosed with ovarian cancer, adjuvant treatment was prescribed to more than 80 percent of the patients, which resulted in five recurrences, and one case of cancer progression, the authors noted.
Counseling May be Needed
As a result of this increased risk of ovarian cancer found in this study, younger women with uterine cancer who undergo conservative management of the disease, ovarian preservation, or both, should be counseled about the additional risks, the investigators stressed.
"In our study, we did not find any family histories that were clearly suggestive of an inherited genetic syndrome," wrote Cass and her group.
In addition, preserving the ovaries in women with both cancers should be done cautiously, they write, given the strong possibility that these women may have an increased susceptibility to reproductive cancer. "This elevated risk may reflect a different underlying biology that is at play in the reproductive tracts of young women who develop endometrial cancer," concluded Cass and her colleagues.
1. Walsh C, Holschneider C, Hoang Y, Tieu K, Karlan B, Cass I. Coexisting ovarian malignancy in young women with endometrial cancer. Obstet Gynecol 2005 Oct;106(4):693-9.
John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include overseeing health news coverage for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.
