A review of studies has revealed that taller women have a slightly higher risk of ovarian cancer. Obesity is also a risk factor among women who have never taken HRT, say international researchers. Previous studies have suggested a link, but there has been conflicting evidence.
The latest research, published in the journal PLoS Medicine, analyzed worldwide data on. It looked at 47 epidemiological studies in 14 countries, including about 25,000 women with ovarian cancer and more than 80,000 women without ovarian cancer.
Lead researcher Prof Valerie Beral of the Oxford University Epidemiology Unit told the BBC, “By bringing together the worldwide evidence, it became clear that height is a risk factor.” She said there was also a clear relationship between obesity and ovarian cancer in women who had never taken HRT. “Ovarian cancer can clearly be added to the list [of cancers linked to obesity],” she added.
Sarah Williams, health information officer at Cancer Research UK, said the study produced a clearer picture of the factors that could affect a woman's risk of developing ovarian cancer, and found that body size was important. “Women can reduce their risk of this and many other diseases by keeping to a healthy weight…For women trying to lose weight, the best method is to eat healthily, eat smaller amounts and be more physically active,” she said.
Commenting on the study, Dr Paul Pharoah, reader in cancer epidemiology at the University of Cambridge, said the increase in risk was small. “If we compare a woman who is 5ft tall with a woman who is 5ft 6in tall, there is a relative difference in ovarian cancer risk of 23%. But the absolute risk difference is small. The shorter woman will have a lifetime risk of about 16-in-a-1000 which increases to 20-in-a-1000 for the taller woman. A similar difference in absolute risk would be seen when comparing a slim woman with a body mass index of 20 to a slightly overweight woman with a body mass index of 30,” he explained.
Although there is a solid body of research linking height and weight with the risk of several different cancers, the evidence relating to ovarian cancer had been inconsistent and the review succeeded in delivering a “fundamentally sound” conclusion, he added.
Ovarian cancer - delays in diagnosis
In another related story it was found that delays in diagnosing ovarian cancer are leading to big compensation payouts.
The Medical Defence Union (MDU) examined 209 complaints made against doctors involving the disease between 2002 and 2011. In 84% of cases a delay in diagnosis was alleged. “In the majority of cases the doctor was accused of making an incorrect diagnosis, although failing to exclude ovarian cancer when there was a family history of the condition and delays in referring patients for tests or to a specialist were also factors,” said Dr Rachel Sutcliffe, an MDU medico-legal adviser. “Sadly in at least 59 cases where the outcome was known, the patient died from the cancer.”
Dr Sutcliffe said, “This is a chameleon disease where typical symptoms, such as stomach pain and bloating, are very similar to those of other common conditions. It is understandable for patients and the families to feel that an opportunity has been missed when doctors do not initially make the correct diagnosis, but given the non-specific nature of the symptoms, failure to diagnose ovarian cancer is not necessarily negligent. However, the seriousness of the condition means it is important that when the diagnosis is considered, doctors take steps to exclude it within a reasonable timescale.”
The Government's national cancer director, Professor Sir Mike Richards, said, “Ovarian cancer is difficult to diagnose and that is one of the reasons why we are providing over £450 million over four years to support earlier diagnosis of cancer. This money will fund a range of activity, including awareness campaigns and increasing GP access to diagnostic tests such as non-obstetric ultrasound to support the diagnosis of ovarian cancer.”
Gilda Witte , chief executive of the charity Ovarian Cancer Action, said National Institute for Health and Clinical Excellence (Nice) guidelines produced last year were designed to improve diagnosis. A woman aged over 50 who presents with any of four major symptoms of ovarian cancer should automatically be referred for a CA125 blood test to identify it, for example.
Early diagnosis of the disease is rare, said Witte. “Diagnosis of ovarian cancer isn't great. A third of cases are diagnosed in A&E, for example,” Witte added. “But the hope is that GPs' knowledge and awareness of the symptoms will gradually improve.” National awareness campaigns were needed to educate both doctors and women, she said.
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