Tortolero-Luna G, Mitchell M F
Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
J Cell Biochem Suppl. 1995;23:200-7. doi: 10.1002/jcb.240590927.
Ovarian cancer is the second most common cancer of the female reproductive system and the leading cause of death from gynecologic malignancies. In 1995, 26,600 women will be diagnosed with ovarian cancer in the U.S., and 14,500 women will die from the disease. Between 1986-1900, the overall age-adjusted incidence was 14.3/100,000 women; mortality was 7.8/100,000 women. Ovarian cancer, rare before age 40, increases steeply thereafter and peaks at ages 65-75. Incidence and mortality rates are higher among white women than among African-American women. Over the last three decades, ovarian cancer incidence has remained stable in high-risk countries, while an increasing trend has been reported in low-risk countries. Despite recent advancements in treatment, the overall five-year survival rates continues to be low (39%). Over 70% of ovarian tumors are diagnosed when regional or distant involvement has already occurred, causing survival rates to remain stable. The etiology of ovarian cancer is poorly understood. Most studies have focused on the epidemiology of invasive epithelial ovarian tumors, while few have explored the epidemiology of epithelial tumors of low malignant potential and nonepithelial tumors. Factors associated with an increased risk for invasive epithelial ovarian cancer include age, race, nulliparity, family history of ovarian cancer, and history of endometrial or breast cancer. Factors associated with a reduced risk are history of one or more full-term pregnancies, use of oral contraceptives, history of breast feeding, tubal ligation, and hysterectomy. Other factors such as infertility drugs, hormone replacement therapy, age at menarche, age at menopause, dietary factors, lactose intolerance, talc use, coffee and alcohol consumption have been suggested, but their role is still inconclusive.
卵巢癌是女性生殖系统中第二常见的癌症，也是妇科恶性肿瘤的主要死因。1995年，美国将有26,600名女性被诊断出患有卵巢癌，14,500名女性将死于该疾病。1986年至1990年期间，总体年龄调整发病率为每10万名女性中有14.3例；死亡率为每10万名女性中有7.8例。卵巢癌在40岁之前很少见，此后急剧增加，并在65至75岁达到峰值。白人女性的发病率和死亡率高于非裔美国女性。在过去三十年中，高风险国家的卵巢癌发病率保持稳定，而低风险国家则报告有上升趋势。尽管最近治疗有所进展，但总体五年生存率仍然很低（39%）。超过70%的卵巢肿瘤在已经发生局部或远处转移时才被诊断出来，导致生存率保持稳定。卵巢癌的病因尚不清楚。大多数研究集中在侵袭性上皮性卵巢肿瘤的流行病学，而很少有人探讨低恶性潜能上皮性肿瘤和非上皮性肿瘤的流行病学。与侵袭性上皮性卵巢癌风险增加相关的因素包括年龄、种族、未生育、卵巢癌家族史以及子宫内膜癌或乳腺癌病史。与风险降低相关的因素是一次或多次足月妊娠史、口服避孕药的使用、母乳喂养史、输卵管结扎和子宫切除术。还提出了其他因素，如不孕药物、激素替代疗法、初潮年龄、绝经年龄、饮食因素、乳糖不耐受、滑石粉使用、咖啡和酒精消费，但它们的作用仍不确定。
