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Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Robert D. Morgan, Andrew R. Clamp, Gordon C. Jayson
Epidemiological studies have suggested that the risk of ovarian cancer is associated with ovulation, in that early onset of menarche and late menopause are associated with a slightly higher risk of ovarian cancer, whereas pregnancy, the contraceptive pill,4 and tubal ligation5 reduce risk. Nulliparity and infertility are associated with increased risk. There is an increased risk of developing borderline ovarian tumors in women who undergo in vitro fertilization treatment.6 There is also evidence that prolonged use of hormone replacement therapy is associated with a small increased risk of ovarian cancer.7
Cancer of the Breast
Published in Jennifer L. Kelsey, Nancy G. Hildreth, Breast and Gynecologic Cancer Epidemiology, 2019
Jennifer L. Kelsey, Nancy G. Hildreth
In some studies, the estrogen receptor level in the tumor has been reported to be positively associated with nulliparity,333 a late age at first birth,321,333 breastfeeding,333 and a history of benign breast disease.333 However, other studies have not found an association with nulliparity321,323 or age at first live birth.323
Answers
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Post-menopausal bleeding should prompt referral for investigation as endometrial carcinoma is a possible diagnosis. It arises from glandular endometrium which has been subjected to oestrogen without opposing progesterone. Risk factors therefore reflect states of increased exposure to oestrogen, such as obesity, nulliparity and late menopause. Other than post-menopausal bleeding, endometrial carcinoma may present as abnormal glandular cells on routine cervical smear tests. Tumours arise in the uterine endometrium and grow into the myometrium, cervix, vagina or peritoneum. Diagnosis is aided by transvaginal ultrasound, which reveals thickened endometrium. Endometrial sampling is then used to obtain tissue for a histological diagnosis. Should tissue be insufficient from endometrial sampling, hysteroscopy, dilatation and curettage can be used to obtain tissue. Treatment depends on the stage, with cancer localised to the uterus and cervix amenable to radical hysterectomy. More advanced tumours can be treated with pre-operative/post-operative radiotherapy, or radium brachytherapy. High-dose progesterone can be used to downstage a tumour. Extension outside the pelvis may be treated with systemic chemotherapy.
Quantitative cervicovaginal fetal fibronectin as a predictor of cervical ripening and induced labour duration in late-term pregnancy
Published in Journal of Obstetrics and Gynaecology, 2023
Modupe Olatokunbo Adedeji, Ayokunle Moses Olumodeji, Adetokunbo Olusegun Fabamwo, Oyedokun Yekini Oyedele
The ages of the study participants ranged between 21 and 43 years with a mean age of 30.4 ± 4.3 years. Women who had late-term pregnancies were majorly nulliparous (72.4%) as against multiparous women accounted for 27.6%. This finding is in sync with reports of other studies that suggest nulliparity as a predisposition to prolonged pregnancy (Tam et al.1999, Ojutiku et al.2002). It took longer than 12 hours (a duration determined arbitrarily) to achieve cervical ripening in 78.2% of nulliparous women and 61.9% of multiparous women in this study. This indicates that nulliparity also predisposes to prolonged cervical ripening as in other similar reports (Blanch et al.1996, Teixeira et al.2012). Cervical ripeness is known to exert a significant influence on induced labour outcomes (Wormer et al.2022).
A clearer view on ovarian clear cell carcinoma
Published in Acta Clinica Belgica, 2022
Aglaja De Pauw, Eline Naert, Koen Van de Vijver, Tummers Philippe, Katrien Vandecasteele, Hannelore Denys
Much of the evidence regarding risk factors for the development of ovarian cancer (OC) reflects findings from studies with a study population of mainly HGSOC. Nevertheless, recent consortial epidemiologic studies reported a unique risk factor profile for every OC subtype. Endometrioid and OCCC had the most similar risk factor associations. The largest of these studies, a pooled analysis of >1.3 million women, identified nulliparity, younger age at menarche, older age at menopause, smoking (>20 pack years), no history of hysterectomy or tubal ligation, and endometriosis as risk factors for OCCC [24,25]. The substantial heterogeneity of individual risk factor associations across OC subtypes supports the idea that subtypes are indeed different diseases. It is increasingly accepted that the majority of OCs originate outside the ovary [26]. Specifically, OCCC is thought to originate from the ciliated cell lineage within both eutopic (fallopian tube) and ectopic endometrial tissue [27].
Perinatal outcomes of pregnancies with prenatally diagnosed foetal congenital heart disease
Published in Journal of Obstetrics and Gynaecology, 2022
Riza Madazlı, Ebru Alıcı Davutoglu, Verda Alpay, Didem Kaymak, Hakan Erenel, Funda Oztunc
The mean age of patients and the rate of nulliparity in our study population are in accordance with those reported in the literature (Perolo et al. 2001; Boldt et al. 2002). The mean gestational age of prenatal diagnosis of foetal CHD in our series is also in accordance with the literature (Nell et al. 2013). Most of our cases (%77) were diagnosed between 17-24 gestational weeks, where 6% and 16% before 17 and after 24 weeks respectively. Most of the foetuses examined in the first trimester were referred to our centre for an extracardiac malformation (67%) and a cardiac anomaly was diagnosed during the foetal evaluation. Association between increased NT and congenital heart defects clearly improves the ability to diagnose CHD in the first trimester (Sairam and Carvalho 2012). Although the ability to image the foetal heart and detect CHD in the first trimester has become more and more accessible, the majority of studies involving the detection of CHD in the first trimester are still poor, well below 50% (Pinto et al. 2012).