China News Service, Beijing, September 4 (Reporter Zhao Fangyuan) Recently, many people have begun to pay attention to topics related to ovarian cancer. Unlike cervical cancer and breast cancer, for which screening methods are very mature, ovarian cancer is hidden and easily ignored by people.
According to the "Ovarian Cancer Diagnosis and Treatment Guidelines (2022 Edition)" issued by the National Health Commission, in my country, the annual incidence rate of ovarian cancer ranks third among female reproductive system tumors, behind cervical cancer and uterine corpus malignant tumors, and is increasing year by year, while the mortality rate ranks first among female reproductive tract malignant tumors.
Li Bin, director of the Department of Gynecology at the Cancer Hospital of the Chinese Academy of Medical Sciences and standing member of the Gynecological Oncology Branch of the Chinese Medical Association, previously pointed out in an interview with Sino-Singapore Health that because the onset site of ovarian cancer is deep in the abdominal cavity and early symptoms lack specificity, most patients are already in the advanced stage when diagnosed.
Abdominal distension and thickening of waist circumference may also be the "alarm" of the ovaries
Li Bin said that the ovaries are hidden deep in the pelvic cavity and are small in size. Early lesions are difficult to reach through routine gynecological examinations. What’s even more troublesome is that the early symptoms of ovarian cancer are highly similar to those of gastrointestinal diseases – bloating, indigestion, loss of appetite, and inexplicable thickening of the waist circumference. These symptoms are easily overlooked or mistaken for digestive system diseases, and some patients may also mistake them for "abdominal obesity" or "irregular menstruation."
Cui Di, deputy chief physician of the Cancer Center of Peking University International Hospital, reminds that if the following symptoms last for more than two weeks and gradually worsen, you should see a gynecologist in time:
1. Unexplained abdominal bloating, abdominal distension, or progressive increase in abdominal circumference, thickening of waist circumference, and tightening of pants;
2. Persistent dull pain or pressure in the lower abdomen;
3. Decreased appetite, easy to feel full after eating, and indigestion;
4. Frequent urination, urgency or difficulty urinating;
5. Significant weight loss and abnormal fatigue in a short period of time;
6. Non-menstrual vaginal bleeding or sudden menstrual disorder.
Ovarian cysts ≠ ovarian cancer, but you need to be wary of chocolate cysts
After many women find ovarian cysts during physical examination, their first reaction is "will it turn into cancer?" In this regard, Cui Di explained that ovarian cysts are common benign lesions in the female reproductive system. They are most likely to occur in women aged 20 to 50 and are divided into two categories: physiological and pathological.
She introduced that physiological cysts are usually related to the menstrual cycle and will disappear on their own; most pathological cysts are benign and only require regular monitoring and surgical intervention when necessary. But there is one kind of cyst that you need to be wary of - ovarian chocolate cyst, medically known as ovarian endometriosis cyst. Although it is a benign lesion and will not become cancerous in most cases, it has characteristics similar to malignant tumors. For example, it may invade surrounding tissues and destroy normal structures, and there is a risk of recurrence after treatment. Common symptoms are dysmenorrhea, menstrual changes, and infertility. What needs to be vigilant is that it has a low risk of malignant transformation (the canceration rate is about 1%) and requires close observation and monitoring.
Cui Di reminded that although not all ovarian cysts will develop into ovarian cancer, once the cyst increases, it is prone to infection, pedicle torsion, bleeding or rupture, which cannot be ignored.
Four groups of people are at higher risk
Based on the National Health Commission's "Ovarian Cancer Diagnosis and Treatment Guidelines" and clinical observations, the following groups are at high risk for ovarian cancer:
One is a family history of cancer. If a first-degree relative (mother, sister) or second-degree relative (aunt, aunt) suffers from ovarian cancer, the risk of the disease is significantly higher than that of ordinary people. The well-known actress Angelina Jolie has a significantly increased risk of breast and ovarian cancer due to a BRCA1 gene mutation. After professional genetic counseling and evaluation, she underwent preventive bilateral mastectomy and bilateral ovarian and fallopian tube preventive resection.
The second is infertility or late menopause. Clinical studies have shown that women who are infertile, have long-term infertility, have late childbearing, and have late menopause have a relatively higher risk of ovarian cancer because they continue to ovulate for a longer period of time.
The third is smoking, obesity, and high-fat diet. Bad lifestyle and eating habits can also increase the risk. Smoking and high-fat diet are clear controllable factors. Obesity is also related to the incidence of ovarian cancer.
The fourth is the age factor. Ovarian cancer can occur at any age, but the incidence rate begins to increase after the age of 40, with the highest incidence occurring between 55 and 64 years old.
Li Bin emphasized that some ovarian cancers have familial genetic tendencies and are related to BRCA1/2 gene mutations. People with BRCA1 mutations enter a high-risk period starting at about 35 years old, and people with BRCA2 mutations have a significantly higher risk starting from about 45 years old. "Women with a family history of ovarian cancer, breast cancer, and Lynch syndrome should be extra vigilant and proactively undergo genetic counseling and genetic testing."
Cui Di suggested that the average woman should have a gynecological ultrasound examination once a year. For high-risk groups such as BRCA1/2 gene mutation carriers, it is recommended to conduct a combined pelvic examination, transvaginal ultrasound and serum CA125 screening every six months starting from the age of 30 to 35. Women with a family history of ovarian cancer or breast cancer are advised to proactively undergo genetic counseling and genetic testing to assess their own risks. (over)
