There is a much higher incidence of ovarian cancer in industrialized countries. Some researchers have implicated talcum powder, which until recently contained asbestos, as a possible cause. Ovarian cancer can occur in any age group, but it is most common in postmenopausal women. Not ovulating—by having children, breastfeeding, using birth control pills or having a condition that interferes with ovulation such as polycystic ovaries—has been shown to offer protection against developing cancer. There may also be a genetic predisposition to this cancer. There are rare families in which several members of the same or different generation develop ovarian cancer. This is known as hereditary ovarian cancer syndrome. It generally affects women in their mid-forties. There may be up to a 50 percent risk of developing ovarian cancer in their lifetime. It can also be inherited through the male side of the family. This syndrome occurs in less than 3 percent of all women who have a positive family history of ovarian cancer. Approximately 7 percent of all women with ovarian cancer do not seem to have a genetic disposition but have a positive family history. Ninety percent of these women have only one other family member with ovarian cancer.
Suggested management in women with a family history for ovarian cancer is as follows: Removal of both ovaries after childbearing or very close follow-up (CA-125 and pelvic ultrasound) for those women who have hereditary ovarian cancer syndrome. If there is a family history of only one relative with ovarian cancer, prophylactic removal of the ovaries is not recommended. When there are two to three relatives who have a history of ovarian cancer, then it is usually very difficult, if not impossible, to determine whether an individual has ovarian cancer syndrome or just a strong positive family history. In these women, prophylactic removal of
