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Cancer comprises the eighth most common cancer affecting women worldwide¹. In this issue of HealthNews, we take a look at 5 important facts about ovarian cancer that every woman must know.

Ovarian cancer refers to a type of gynaecological cancer that arises from the uncontrolled growth of malignant cells in the ovaries.

In Singapore, ovarian cancer is the sixth most common cancer affecting women, with over 1,800 new cases diagnosed in the period of 2016-2020 . It is the sixth most common cause of cancer deaths among Singaporean women, behind breast, colon, lung, pancreas and liver cancers.

As ovarian cancer can affect women of any age, it is important for women to be aware of these important facts about the disease:

FACT #1
Look out for these common signs and symptoms of ovarian cancer

Ovarian cancer is usually asymptomatic in its early stages. Signs and symptoms may only be noticeable at later stages when the disease is more advanced.

Some common signs and symptoms of ovarian cancer include:

• Abdominal bloating and swelling
• Indigestion, gas or nausea
• Loss of appetite
• Significant weight loss
• Changes in bowel habits
• Abnormal bleeding after menstruation and menopause
• Pelvic pain and discomfort

It may be easy to mistake these signs and symptoms for other common conditions which affect the gastrointestinal tract. If you experience one or more of these symptoms, seek medical advice from a doctor.

FACT #2
The risk of ovarian cancer increases with age

The risk of ovarian cancer increases with age³. The disease tends to develop in older, post-menopausal women over the age of 50.

While ovarian cancer is rare in younger women, they can get the disease too.

Besides age, there are other risk factors that can increase a woman's risk of developing ovarian cancer. These include:

• A family history of cancer
• Obesity
• Postmenopausal hormone replacement therapy
• Endometriosis
• Early menstruation or late menopause
• Never having been pregnant

FACT #3
Over 10% of ovarian cancer cases are linked to genetic mutations

As many as 10-15 percent of ovarian cancer cases are linked to genetic mutations⁴.

Common genetic mutations associated with ovarian cancer are mutations in the BRCA1 and BRCA2 genes, as well as Lynch syndrome. Families harbouring these genetic mutations or disorders may have a higher risk of developing ovarian cancer, as well as other gynaecological cancers such as breast and uterine cancers.

Genetic mutations in other less common genes have also been found to increase the risk of developing ovarian cancer. Your family history of cancer may offer clues that you may have these genetic mutations or disorders in your family.

FACT #4
There is currently no standard screening for ovarian cancer

There is currently no standard or routine screening for women with no known risk factors for ovarian cancer. This can make it difficult to catch the disease at an early stage.

For women with a strong family history of cancer, genetic counselling and testing may be recommended. Genetic testing involves looking for mutations in the genes. Knowing if you have mutations linked to ovarian cancer can increase your chance of discovering if you are at higher risk of developing the disease.

Women at high risk of developing ovarian cancer may be recommended to go for annual pelvic examinations, vaginal ultrasounds and blood tests for tumour markers. Being aware of the common signs and symptoms associated with the disease can also help detect the cancer early.

FACT #5
These factors may reduce your risk of ovarian cancer

Some risk factors for ovarian cancer, like age or family history, cannot be modified. However, there are ways to reduce your risk of developing ovarian cancer. These include:

• Early pregnancy
• Breastfeeding
• Avoid hormone replacement therapy after menopause
• Maintaining a healthy weight, avoid obesity
• Keeping a healthy diet
• Stop smoking
• Regular exercise

¹World Cancer Research Fund International, 2020

²Singapore Cancer Registry Annual Report 2020

³HealthXChange, 2023

⁴National Cancer Centre Singapore, 2022