About GYN Cancer
Though we may not fully understand exactly why one person develops an illness and another doesn’t, research has shown that there are similarities and patterns among those who do develop certain diseases which may help indicate what factors in a person’s family history, medical history, lifestyle or environment may increase her chance of developing that disease.
What we term gynecologic cancer risk factors are those things that may increase a woman’s chance of developing a certain type of gynecologic cancer. Some risk factors can be avoided, while others cannot. Each type of gynecologic cancer has its own corresponding risk factors, which are as follows:
Significant risk factors include early age at first intercourse, multiple sexual partners, multiparity (giving birth more than twice), infection with Human Papilloma Virus (HPV)—specifically Types 16 and 18, use of non-barrier methods of birth control, sexual contact with high-risk males, and smoking.
Patients with low parity, decreased fertility, and delayed child-bearing appear to be at greater risk for ovarian cancer. The risk increases with age and peaks at about 70 years. There also appear to be genetic inherited forms which account for 3 to 5% of all cases of ovarian cancer. These inherited forms of ovarian cancer tend to occur at younger ages (an average of ten years before non-heritable ovarian cancer). A dysfunctional BRCA 1/2 gene plays a major role in these syndromes. There are three recognized hereditary forms of ovarian cancer which include the following:
· Site Specific Familial Ovarian Cancer
· Breast-Ovarian Familial Cancer Syndrome
· Lynch II Syndrome (also known as hereditary non-polyposis colorectal cancer, which is responsible for a higher risk of uterine, breast and ovarian cancer clusters in first and second degree relatives).
Note: Use of oral contraceptives appears to have a protective effect which may last up to 10 years.
Recognized risk factors often account for a chronic estrogenized state (due to internal or external influences). These factors include nulliparity (never having given birth), early menarche (onset of menstruation), late menopause, obesity, chronic disease (e.g., diabetes, hypertension), and unopposed estrogen therapy.
Possible risk factors include low socioeconomic status, history of HPV infection, chronic vaginal irritation, prior abnormal pap test with cervical dysplasia (precancerous cells in the cervix), prior hysterectomy (which represents 59% of patients with primary vaginal cancer), and prior treatment for cervical cancer.
*A subset of patients of special note includes those who have had in-utero exposure to DES during the first half of pregnancy (Diethylstilbestrol, or DES, was a drug used from 1940 to 1971 to try to prevent adverse pregnancy outcomes). The risk for an exposed fetus to develop clear cell carcinoma of the vagina later in life is 1:1000 with peak age at diagnosis being 19 years.
The cause of vulvar cancer appears to be multifactorial but some associated risk factors appear to be advanced age, low socioeconomic class, hypertension, diabetes, prior lower genital tract malignancy (cervical cancer), and immunosuppression. In addition, a history of granulomatous venereal ulcers and a history of HPV may increase your risk of developing vulvar cancer.