Epithelial ovarian cancer in Southern Africa

Abstract

Introduction Ovarian cancer is the eighth most frequently diagnosed cancer and currently is the leading cause of death from gynaecologic cancer. Globally, the five-year survival is only 15-20% for patients with clinically advanced ovarian cancer despite aggressive surgery and platinum based chemotherapy. 1 The poor overall prognosis is primarily due to the fact that the disease is almost invariably advanced when the diagnosis is made. In Africa the most common malignancies in females are cancer of the cervix (23.3%), breast cancer (19.3%), Kaposi's sarcoma (5.1%), liver cancer (5.0%), non-Hodgkin lymphoma (38%), and cancer of the ovary (3.7%).(1) In South Africa, the National Cancer Registry reported 529 cases of ovarian cancer in 2001. Of these cases, 207 were in white patients, 225 in black patients, 69 in coloured patients and 16 were reported in the Asian community. 2 Known risk factors include age, primigravidity, history of breast, endometrial and colon cancer, intraperitoneal talc powder or vegetable fibre, ovarian hormonal hyperstimulation, delayed childbearing, high-fat diet, fertility drugs and the Lynch II syndrome. The use of the combined oral contraceptive pill, sterilisation and a previous hysterectomy appear to have a protective effect and decrease the incidence.