Risk Factors

The risk of ovarian cancer is greater among women whose mothers or sisters had ovarian cancer and among women with a history of breast cancer. Some rare genetic syndromes are associated with ovarian cancer, including one characterized by colorectal cancer, endometrial cancer, and ovarian cancer.

Women who have never had children and women who have had difficulty becoming pregnant are at greater risk for ovarian cancer. Conversely, the more full-term pregnancies and the more incomplete pregnancies women have had and the more time spent breast feeding, the lower their risk of ovarian cancer. Oral contraceptive use also reduces the risk; the longer they are taken the more the risk is reduced. Tubal ligation and hysterectomy are associated with a reduced risk of ovarian cancer.

Age at first birth, age at first menstruation, age at menopause, and estrogen replacement therapy do not appear to affect the risk of ovarian cancer. Several studies found dietary fat to be associated with a small increased risk, but this needs to be studied more. Alcohol, coffee, and tobacco appear not to affect the risk of ovarian cancer.

Prevention and Control

At present there are no known methods of preventing ovarian cancer. Early detection of ovarian cancer can be achieved by periodic thorough pelvic examinations. The American Cancer Society recommends that women over age 40 have this type of checkup every year.

Incidence and Mortality in the U.S.

An estimated 25,400 new cases of ovarian cancer are expected to occur in the U.S. in 1998. It is about twice as common among white women as among black women. Since 1973, the incidence rate of ovarian cancer has increased slightly. The incidence of ovarian cancer increases with age until age 75 and then decreases. One year after diagnosis of ovarian cancer 76 percent of patients are still alive; the five-year survival rate is 46 percent. For 1998, approximately 14,200 deaths due to ovarian cancer are expected to occur in the U.S. Since 1973 mortality due to ovarian cancer has declined.

Incidence in New Jersey - 1986-1996

Tables 41 through 43 show the incidence data by county for ovarian cancer for the years 1986 through 1996. Figure 14 depicts the statewide trends which are that white women had higher rates than black women. The counties followed the same pattern, except that in Morris, Ocean, Salem, and Somerset black women had higher rates than white women (see Table 41). However, the rates for black women in these counties should be interpreted cautiously because they are based on small numbers. In general, the statewide rates have decreased since 1991, though not as consistently for black women as for white women (see Figure 14).

Conclusion

The best public health measure to address ovarian cancer is early detection through periodic thorough pelvic exams. Decreased fat in the diet may reduce the chances of ovarian cancer.

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COUNTY	1986		1987		1988		1989		1990		1991		1992		1993		1994		1995		1996 (Prelim.)
	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate
Atlantic	19	12.9	15	12.9	18	15.3	17	16.0	19	14.4	22	16.1	29	21.9	26	20.9	24	16.5	22	15.4	18	14.4
Bergen	106	18.6	109	20.2	103	18.7	115	19.6	119	21.6	109	19.1	92	15.5	112	20.0	93	15.9	92	16.0	97	16.9
Burlington	29	16.2	26	14.1	30	15.6	43	22.3	40	21.0	36	18.8	36	16.7	31	14.1	37	18.1	37	17.5	34	15.8
Camden	41	15.4	35	13.5	40	15.1	46	17.3	44	16.6	52	18.5	62	23.7	42	17.3	42	16.4	42	15.6	30	12.3
Cape May	7	13.5	---	---	8	13.1	12	18.3	15	22.7	12	14.8	16	20.4	14	25.0	9	13.6	11	12.3	7	8.6
Cumberland	11	15.9	11	16.0	15	20.2	14	18.8	15	22.4	15	18.5	16	20.5	11	16.0	10	11.3	9	11.3	17	24.3
Essex	64	17.5	72	21.8	53	15.5	55	15.3	64	20.2	68	22.4	80	24.5	52	17.2	46	14.9	56	19.7	53	15.5
Gloucester	22	20.6	18	15.7	19	18.8	21	18.3	12	9.6	20	16.5	22	18.4	19	14.9	20	15.8	14	10.5	20	15.3
Hudson	39	12.4	47	15.2	50	16.1	57	18.9	50	17.5	56	18.2	42	13.2	46	16.3	57	19.7	39	13.7	34	12.0
Hunterdon	11	19.5	8	15.3	8	13.8	6	10.6	10	17.7	9	16.2	14	24.3	15	24.0	11	19.7	16	24.3	12	18.9
Mercer	30	16.2	33	21.2	29	18.8	33	19.1	27	16.2	34	19.8	27	15.0	38	22.6	22	9.6	24	14.0	25	15.3
Middlesex	56	15.9	59	16.7	71	19.6	62	17.2	58	17.0	51	14.0	69	19.7	63	17.2	75	20.8	60	17.2	65	17.0
Monmouth	53	17.9	48	15.1	56	17.3	58	19.0	44	13.7	61	18.9	60	18.7	65	20.0	61	18.6	63	20.5	52	16.7
Morris	56	25.0	40	16.1	46	19.6	37	16.1	50	20.7	38	15.3	42	17.2	41	17.1	43	16.7	43	17.0	38	15.0
Ocean	51	18.5	53	16.6	60	19.2	61	16.2	62	15.2	74	19.6	58	19.2	48	13.2	79	20.4	67	18.8	71	18.5
Passaic	36	14.3	55	21.6	45	18.1	44	16.1	43	16.0	47	17.9	35	14.1	48	18.5	45	17.9	40	16.3	39	15.9
Somerset	25	20.2	17	13.1	19	14.4	13	10.4	24	18.1	20	14.6	20	14.7	24	17.0	22	16.0	19	12.6	17	12.6
Sussex	17	28.7	13	21.3	13	20.8	14	24.4	13	19.8	9	12.1	14	17.5	12	15.0	10	14.9	12	18.3	12	16.7
Union	41	13.7	50	16.4	64	21.9	55	17.9	49	17.6	72	25.2	56	20.1	50	16.5	52	19.6	53	17.6	46	15.3
Warren	11	20.4	13	20.2	11	16.4	13	21.1	9	15.4	9	15.6	13	19.1	14	24.4	17	25.4	10	13.8	9	15.3
STATE	727	16.8	730	17.0	763	17.7	782	17.7	771	17.8	820	18.3	806	18.2	779	17.6	779	17.3	732	16.4	700	15.5

¹Incidence rates - per 100,000 females, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with six or more years of fewer than five cases each year were removed from the table - Salem county. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

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