DOES PREGNANCY PROTECT AGAINST OVARIAN CANCER?

doi:10.1016/S0140-6736(78)90925-X

The Lancet

Volume 311, Issue 8073, 20 May 1978, Pages 1083-1086

https://doi.org/10.1016/S0140-6736(78)90925-X Get rights and content

Abstract

A clear inverse relation between average completed family size and mortality from ovarian cancer in different populations of women is seen from one country to another; for successive generations of women living within the same country; in married and single women; and in different social, religious, immigrant, and ethnic groups. The findings suggest that pregnancy—or some component of the childbearing process—protects directly against ovarian cancer. This protection seems to persist throughout life. The more-than-twofold increase in the age-standardised ovarian-cancer death-rate in England and Wales since 1931 can be explained largely by changes in the average completed family size.

References (5)

Office of Population Censuses and Surveys
Studies on Medical and Population Subjects No. 29
(1975)
D.J. Joly et al.
Am. J. Epidemiol.
(1974)

There are more references available in the full text version of this article.

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Citation Excerpt :
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Retrospective study based on clinical histories from patients diagnosed and treated at our hospital for ovarian cancer and pregnancy from 1987 to 2005.
Fifteen cases of ovarian cancer were diagnosed among pregnant women; the ratio is 0.11/1000 deliveries. Among them, 66.6% of patients were asymptomatic, and 86.6% had been diagnosed via ultrasound. Of the diagnosed tumors, 40% were malignant epithelial tumors, 26.6% of them were of low malignant potential. The 20% were germinal cell tumors. Of these primary ovarian malignancies, the 59.9% were stage I. The remaining 20% were metastatic tumors. Forty percent of the total were treated conservatively (salpingo-oophorectomy) and 60% with hysterectomy and bilateral salpingo-oophorectomy. Chemotherapy was administered to 66.6% of the patients, in two cases during pregnancy. Eighty percent of the newborns were healthy and presented no sequelae or malformations. Global survival at 5 years was 76%.
Ovarian cancer is rare in pregnant women. Most malignant ovarian neoplasias in pregnant women are at early stages and are associated with good prognosis both for the mother and for the neonate.
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The literature on obesity, fat intake, energy balance and exercise is reviewed with respect to cancer risk in man. Animal experiments in the field are analyzed to find support for the epidemiological observations. The problems involved in the interpretation of the human and animal data are discussed and it is attempted to extract the essence of the present body of knowledge. No doubt obesity is associated with certain cancers but a causal relationship is not fully established. Exercise to a moderate degree for prolonged periods of time evidently confers a decreased risk of some cancers. Causality is difficult to establish in human observations but animal experiments make such a relation appear very likely. Since a fat-rich diet (in man) is usually a diet relatively poor in fruits and vegetables it is difficult to ascribe an increased cancer risk on a fat-rich diet to the intake of fat alone as a shortage in the intake of fruits and vegetables may well be an important factor. Again animal experiments generally support the idea that fat is a promoter for a number of experimental cancers. The type of fat is probably important although some controversies still exist concerning the relative effect of the different types of fatty acids.
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Occasional SurveyDOES PREGNANCY PROTECT AGAINST OVARIAN CANCER?

Abstract

Studies on Medical and Population Subjects No. 29

Am. J. Epidemiol.

Occasional Survey
DOES PREGNANCY PROTECT AGAINST OVARIAN CANCER?