Risk factors in ovarian cancer.

For 50 years, the three- and five-year survival rates of under 40% for invasive ovarian cancer in the USA have not significantly changed. Identifying those women who have a greater probability of developing the disease should contribute to improving survival. Our 3-year case-control study of 298 women from the metropolitan Washington, DC, area with primary epithelial ovarian cancer revealed a woman is at greater risk of developing ovarian cancer if she has a family history of the disease, experiences difficulty becoming pregnant, and has a normal menopause with hot flashes. Her risk for the disease is diminished with multiparity, a history of dysmenorrhea, and hysterectomy. Physicians should consider these risk factors when performing pelvic examinations in women and coordinate them with known changes in ovarian size and procedures to view the ovaries which may permit earlier recognition of ovarian cancer.