Who’s at the greatest risk of ovarian cancer?

Amna Nawaz:

Let's take a larger look now at ovarian cancer in this country. In the United States this year, nearly 20,000 women will receive a new diagnosis of ovarian cancer and more than 12,000 women will die from the disease.

Dr. Carol Brown is a gynecologic cancer surgeon and chief health equity officer at Memorial Sloan Kettering's Cancer Center. She joins me now.

Dr. Brown, welcome to the "NewsHour" and thank you for joining us.

You have just heard Chris Evert's story there, learning only of her own risk because of her sister's late diagnosis. But what should the rest of us understand about risk factors? Who should consider themselves at the greatest risk of ovarian cancer?

Dr. Carol Brown, Memorial Sloan Kettering Cancer Center:

Thank you so much for having me on this evening and for focusing on this really important topic.

And I think Chris Evert's story is really typical and highlights the greatest risk for women who have ovarian cancer is actually family history, as you heard in her story. So the women who are at highest risk of getting ovarian cancer in the United States and around the world are women who have a first-degree relative, which means either a mother or a sister, with ovarian cancer or relatives, first- or second-degree relatives with ovarian cancer or breast cancer.

So this really ties in to Chris Evert's story, in that her having a sister with ovarian cancer. So, those are the women that are at highest risk. And it shows the importance of knowing your family history. It's really critical.

Amna Nawaz:

So, Dr. Brown, we know early detection is key. And the American Cancer Society says that only 20 percent of ovarian cancers are found at what you consider an early stage.

So, because there aren't specific symptoms, per se, how can it be detected early? What should people know?

Dr. Carol Brown:

So, what everyone should know is, again, it really ties back to knowing what are your risks and what you can do to reduce your risks.

So knowing your family history really ties into what we have learned in the last decade or so about ovarian cancer and the highest risk being related to family history. It's because the answer is really in your genes. We know that there are mutations that you could have inherited from your parents. And it's not just BRCA1 and BRCA2, but there are four or five major genes that increase your risk for ovarian cancer.

And so the best way to diagnose it early is what happened in Chris Evert's situation, where she had what we call a risk-reducing surgery to prevent her from getting ovarian cancer. And it was found that, early on, there was the very beginnings, the earliest stages.

So, knowing your family history and getting that really critical genetic testing is the most important way you can find it early.

Amna Nawaz:

What about disparities when it comes to access to that kind of testing, having and being able to early-detect ovarian cancer? Do we see that play out in our health system?

Dr. Carol Brown:

We definitely see the issue of disparities, differences in outcome in ovarian cancer, as we do with many other cancers.

And it is really true that one of the really important things to know is knowing about this family history, but getting access to genetic testing and counseling about your genetic risk, such as Chris Evert had.

And we do know, we have done some studies at Sloan Kettering that show that women of color are less likely to have access to genetic testing, less likely be counseled to get genetic testing. So, we really want women and all people to know that, if you have got a family history of cancer, ask your clinician about getting genetic testing for cancer.

Amna Nawaz:

Dr. Brown what about men? I mean, if they have a family history, a blood relative who's been positive for the BRCA1 or 2 gene, does that carry a risk for men as well?

Dr. Carol Brown:

So, BRCA1 and BRCA2, as with some of the other genes associated with increased risk for ovarian cancer, it's not limited — the risk is not limited to just ovarian cancer.

So, in BRCA1 and BRCA2, there's also an increased risk for pancreatic cancer, prostate cancer. For some of the other genes associated with increased risk of ovarian cancer like Lynch syndrome, this is an increased risk for colon cancer, bladder cancer.

So, for men, as well as women, for all people that have these family histories of cancers, it is so critical to take advantage of the new technology, to get the genetic testing and counseling done.

And then you know that there things you can do to reduce your risk.

Amna Nawaz:

And what are some of those things? Tell us about that.

Dr. Carol Brown:

There's some very simple things, particularly for young women.

And it might be surprising for the audience to know, but oral contraceptives, taking birth control pills for just five years cuts your risk of getting ovarian cancer in half. So one of the things that we counsel women who have children who have BRCA1 or BRCA2, they want to know, what can I do? What — how can I reduce my daughter's risk? Taking birth control pills will cut your risk in half.

Another thing is healthy diet, exercise and maintaining the ideal body weight. This is also something that can really reduce your risk of getting ovarian cancer. But the most important thing is what Chris Evert did, which is to get risk-reducing surgery when you are found to be carrying an inherited mutation that increases your risk for ovarian cancer.

Amna Nawaz:

Such important and necessary useful health information we hope can help a lot of people out there.

Dr. Carol Brown of Memorial Sloan Kettering's Cancer Center joining us tonight, thank you so much for your time.

Dr. Carol Brown:

Thank you.