Etiologic Mechanisms in Epithelial Ovarian Cancer
Ovarian cancer (OC) is a moderately common neoplasm of older women that is both difficult to diagnose and treat. Almost 2% of women are affected over the lifetime. It is the fourth most frequent cause of cancer death among women, after lung, breast, and colorectal cancer. The established risk factors (low parity, non-use of oral-contraceptives, germline BRCA1/2 mutation) account for a portion of disease occurrence, but mechanisms by which these factors affect risk of developing OC are not fully understood. The purpose of this chapter is to consider evidence for and against the two main etiologic hypotheses, concerning incessant ovulation and excessive gonadotropins. We use the term "ovarian cancer" to denote the borderline (low malignant potential) and invasive tumors of the surface epithelium of the ovary that constitute the more than 90% of all nonbenign ovarian neoplasms of adult women. Germ-cell, stromal, and other primary tumors also occur but are not the main focus here. Some etiologic heterogeneity may also exist among the epithelial subtypes, this is discussed by the author in detail elsewhere (1).
KeywordsObesity Adenoma Oncol Progesterone Androgen
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