Deck 22: Epidemiology of Ovarian Cancer

Question 1

Ovarian cancer was diagnosed in 295,414 women and caused 184,799 deaths in the world population during 2018.

Answer 1

True

Question 2

Ovarian cancer develops silently, and as a consequence, more than 70% of cases are diagnosed too late for effective therapy.

Answer 2

True

Question 3

An elevated serum level of the ovarian protein, CA-125, is a useful biomarker for the early detection of ovarian cancer.

Answer 3

False

Question 4

Ovarian cancer occurs in a familial setting approximately 50% of the time.

Question 5

Mutant forms of the breast cancer genes, BRCA-1 and BRCA-2, also predispose to ovarian cancer.

Question 6

The classical risk factors for breast cancer and ovarian cancer are similar and include familial and genetic predisposition, early menses, delayed reproductive history, nulliparity, absence of lactation, late menopause, and the natural process of aging.

Question 7

The "incessant ovulation model" of ovarian carcinogenesis applies primarily to fertile women.

Question 8

Fertility drugs have been found to increase ovarian cancer risk, most likely by inducing secretion of gonadotropic hormones (FSH and LH) by the hypothalamus.

Question 9

At the time of diagnosis, approximately what percentage of ovarian cancer cases are found to have metastatic disease?

A) 25%
B) 50%
C) 70%
D) 90%

Question 10

Mutations in all of the genes listed below predispose to ovarian cancer except:

A) BRCA-1.
B) BRCA-2.
C) MSH-2.
D) APC.

Question 11

Exogenous risk factors for ovarian cancer include all of the following except:

A) fertility drugs.
B) perineal talcum powder.
C) estrogen replacement therapy.
D) use of the synthetic male hormone danazol.

Question 12

Endogenous risk factors for ovarian cancer include all of the following except:

A) late first pregnancy.
B) endometriosis.
C) polycystic ovaries.
D) early menopause.

Question 13

Aromatase-catalyzed biosynthesis of estrogen by adipose tissue has been advanced to explain observations of elevated ovarian cancer risk in association with which of the following risk factors?

A) Nulliparity
B) Late first pregnancy
C) Obesity
D) Anovulatory cycles

Question 14

Epidemiologic investigations have consistently found that ovarian cancer risk is decreased by:

A) sustained use of oral contraceptives.
B) estrogen replacement therapy.
C) high dietary intake of lactose.
D) high dietary intake of saturated fat.

Question 15

What profile of pituitary hormones is most likely to promote the development of ovarian cancer?

A) High FSH and high LH
B) Low FSH and low LH
C) High FSH and low LH
D) Low FSH and high LH

Question 16

Serum levels of what ovarian protein have been used to monitor the regression/progression of disease in women with ovarian cancer?

A) A fetoprotein
B) Carcinoembryonic antigen (CEA)
C) CA-125
D) CRP

Question 17

Describe the global burden of ovarian cancer.

Question 18

Briefly discuss the main features of the hypothalamic-pituitary-ovarian axis and their relevance to the development of ovarian cancer.

Question 19

Discuss the reproductive risk factors for ovarian cancer.

Question 20

Discuss the hallmarks of familial ovarian cancer and the effects of mutant forms of BRCA-1 and BRCA-2.

Question 21

Discuss exogenous risk factors for ovarian cancer.

Question 22

Characterize the recent decline in ovarian cancer rates in the United States and discuss potential reasons for this trend.

Question 23

Propose a mechanism by which obesity increases the risk of developing ovarian cancer.

Question 24

Discuss why survival is poor following the diagnosis of ovarian cancer.