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NCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Ovarian Cancer - October 2002
National Cancer Institute®
Last Modified: October 1, 2002
- Oral contraceptives and epithelial ovarian cancer. Does dose matter?
- Dietary antioxidants, supplements, and risk of epithelial ovarian cancer.
- Enhancing the anticancer efficacy of camptothecin using biotinylated poly(ethylene glycol) conjugates in sensitive and multidrug-resistant
- Immunohistochemically detected p53 mutations in epithelial tumors and results of treatment with chemotherapy and radiotherapy. A
- Cancer risk estimates for BRCA1 mutation carriers identified in a risk evaluation program.
- Inactivation of BRCA1 and BRCA2 in ovarian cancer.
- Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer.
- Oral contraceptives and neoplasia of the ovary.
- Pooled analysis of 3 European case-control studies of epithelial ovarian cancer: III. Oral contraceptive use.
- Tubal sterilization, hysterectomy, and the subsequent occurrence of epithelial ovarian cancer.
- The influence of lactose consumption on the association of oral contraceptive use and ovarian cancer risk.
- Risk factors for epithelial ovarian tumours of borderline malignancy.
- Risk factors for epithelial ovarian cancer in Beijing, China.
- Worldwide variations in the lifetime probability of reproductive cancer in women: implications of best-case, worst-case, and likely-case
- The prevention of breast cancer through reduced ovarian steroid exposure.
- An epidemiologic study of ovarian cancer. Part 11: Oral contraceptive use and menstrual events.
- An epidemiologic study of epithelial carcinoma of the ovary.
- Epithelial ovarian cancer and combination oral contraceptives.
- Factors affecting the association of oral contraceptives and ovarian cancer.
- Ovarian cancer: histogenetic classification, histologic grading, diagnosis, staging, and epidemiology.
- Epidemiological factors and prophylaxis of ovarian tumors.
- Events of reproductive life and the incidence of epithelial ovarian cancer.
- Oral contraceptives and ovarian cancer.
- Cigarette smoking and the risk of epithelial ovarian cancer.
- Cigarette smoking and the risk of female reproductive cancer.
- An epidemiologic case-control study of ovarian cancer and reproductive factors.
- The effect of tubal ligation on the incidence of epithelial cancer of the ovary.
- Oral contraceptives containing chlormadinone acetate and cancer incidence at selected sites in the German Democratic Republic--a
- The clinical relevance of the epidemiology of ovarian cancer.
- The epidemiology of ovarian cancer in Greece: a case-control study.
- Hormonal factors and risk of ovarian germ cell cancer in young women.
- Personal and environmental characteristics related to epithelial ovarian cancer. I. Reproductive and menstrual events and oral contraceptive use.
- Risk factors of ovarian cancer of epithelial origin: a case control study.
- Case-control study of borderline ovarian tumors: reproductive history and exposure to exogenous female hormones.
- Population-based case-control study of ovarian cancer in Shanghai.
- Menstrual factors and the risk of epithelial ovarian cancer.
- The effects of oral contraceptives and parity on ovarian cancer trends in women under 55 years of age.
- Risk factors for ovarian cancer: a case-control study.
- A case-control study of oral contraceptive use and invasive epithelial ovarian cancer.
- Parity, contraception, infertility, and the risk of epithelial ovarian cancer.
- Ovarian and endometrial cancers.
- A case-control investigation on cancer of the ovary in Bangalore, India.
- Reduced risk of ovarian cancer in women with a tubal ligation or hysterectomy. The World Health Organization Collaborative Study of
- Tubal ligation and the risk of ovarian carcinoma.
- Oral contraceptive pills. Prevention of ovarian cancer and other benefits.
- Low-malignant potential epithelial tumors of the ovary: a clinicopathological study.
- Borderline ovarian tumours: retrospective analysis of twenty-one cases.
- [Oral contraceptives and endometrial and ovarian carcinomas]
- Polymorphic CAG repeat length within the androgen receptor gene: identification of a subgroup of patients with increased risk of ovarian
- Role of surgery in the prophylaxis of hereditary cancer syndromes.
- Periostin secreted by epithelial ovarian carcinoma is a ligand for alpha(V)beta(3) and alpha(V)beta(5) integrins and promotes cell
- Women's decisions regarding management of breast cancer risk.
- Mammographic appearance of axillary lymph node calcification in patients with metastatic ovarian carcinoma.
- Calcified ovarian metastases.
- Paediatric extracranial germ cell tumours: a retrospective review.
- Occupational exposures and the risk of ovarian cancer in Sweden.
- Endometriosis. Clinicians and patients should be aware of association between endometriosis and malignancies.
- Contribution of BRCA1 and BRCA2 mutations to breast and ovarian cancer in Pakistan.
- BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes.
- Lymph node disorders and prognostic value of nodal involvement in patients treated for a borderline ovarian tumor: an analysis of a series
- [Hormone therapies and ovarian cancer]
- Risk of ovarian cancer in breast-cancer patients with a family history of breast or ovarian cancer: a population-based cohort study.
- [CT diagnosis of fibrothecoma and fibroma of the ovary]
- Immunization of cancer patients with a HER-2/neu, HLA-A2 peptide, p369-377, results in short-lived peptide-specific immunity.
- Failure of BRCA1 dysfunction to alter ovarian cancer survival.
- [Analysis of mutations in genes BRCA1 and BRCA2 among patients with breast and ovarian cancer in northern Portugal and Galicia]
- Immunohistochemical staining in the distinction between primary endometrial and endocervical adenocarcinomas: another viewpoint.
- Prostatic tissue in mature cystic teratomas of the ovary: a report of four cases, including one with features of prostatic adenocarcinoma, and
- Malignant mullerian mixed tumor arising from ovarian serous carcinoma: a clinicopathologic and molecular study of two cases.
- [Management of dermoid ovarian cysts. Report of 58 cases]
- Significant contribution of large BRCA1 gene rearrangements in 120 French breast and ovarian cancer families.
- Expression of the anti-apoptotic gene survivin correlates with taxol resistance in human ovarian cancer.
- Risk-of-malignancy index in preoperative evaluation of clinically restricted ovarian cancer.
- Early detection and screening for ovarian cancer: does physician specialty matter?
- p53 and HER-2/neu overexpression in ovarian borderline tumors.
- Micronutrients and ovarian cancer: a case-control study in Italy.
- Gene expression profiles of BRCA1-linked, BRCA2-linked, and sporadic ovarian cancers.
- [The incidence of ovarian tumors in the third trimester of pregnancy]
- [Ovarian tumors in pregnancy]
- [Ovarian cancer in a pregnant woman and limited treatment strategy--a case report]
- [Coexistence of ovarian carcinoma with pregnancy--case report]
- [Ovarian tumors in the reproductive age group]
- [Ovarian tumors in pregnancy]
- [Ovarian tumors in pregnancy in the material of the Department of Gynecology and Oncology Collegium Medicum of Jagiellonian University in
- [The diagnostic value of ultrasound examination in detection of ovarian tumors during pregnancy]
- [The number and histopathologic type of ovarian tumors operated during cesarean section at the Polish Mother's Health Institute between
- Gamma-synuclein promotes cancer cell survival and inhibits stress- and chemotherapy drug-induced apoptosis by modulating MAPK pathways.
- Women's experiences with ovarian cancer: reflections on being diagnosed.
- Re: Gene expression profiles of BRCA1-linked, BRCA2-linked, and sporadic ovarian cancers.
- 2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer.
- The use of PET scanning in ovarian cancer.
- The role of p53 mutation in BRCA1-associated ovarian cancer.
- Expression of multidrug resistance-associated markers, their relation to quantitative pathologic tumour characteristics and prognosis in advanced
- Prognostic significance of ultrasound derived intratumoral peak systolic velocity in epithelial ovarian cancer.
- Mucinous tumors of the ovary: analysis of 38 cases.
- Nongenital metastatic cancers of the ovary: a clinical analysis.
- Dynamic alterations of the extracellular environment of ovarian surface epithelial cells in premalignant transformation, tumorigenicity, and
- Alpha(v)beta(6) integrin-A marker for the malignant potential of epithelial ovarian cancer.
- Association of galactose-1-phosphate uridyltransferase activity and N314D genotype with the risk of ovarian cancer.
- [Demonstration of plasmacytes in gingival immune defense units in dermoid cysts of the ovary]
- Trends in the incidence of endometrial and ovarian cancers.
- A sociobehavioural perspective on genetic testing and counselling for heritable breast, ovarian and colon cancer.
- [The enhanced lethality of cells in suspension during simultaneous exposure to pulsed electrical and shock-wave acoustic fields]
- FSH-regulated gene expression profiles in ovarian tumours and normal ovaries.
- Prognostic factors of secondary ovarian carcinoma.
Table of Contents
1
UI - 11027080
AU - Sanderson M; Williams MA; Weiss NS; Hendrix NW; Chauhan SP
TI -
Oral contraceptives and epithelial ovarian cancer. Does dose matter?
SO - J Reprod Med 2000 Sep;45(9):720-6
AD - Department of Epidemiology and Biostatistics, University of South
Carolina, Columbia 29208, USA. msanderson@sph.sc.edu
OBJECTIVE: To determine the risk of ovarian cancer among women who use
low-estrogen-dose oral contraceptives. STUDY DESIGN: The study used data
on white women under 70 years of age who had been enrolled in a
population-based case-control study conducted between 1986 and 1988 in
three western Washington counties. Women with ovarian cancer (n = 276)
were ascertained through a population-based cancer registry, and
controls (n = 391) were selected by random digit dialing. Unconditional
logistic regression was used to estimate the risk of ovarian cancer
associated with oral contraceptive use. RESULTS: After adjustment for
age and parity, women who took oral contraceptives for at least three
months were at decreased risk of ovarian cancer (odds ratio [OR] 0.8,
95% confidence interval [CI] 0.5-1.1) relative to women who never used
this form of contraception. The reduced risk of ovarian cancer was
present among women whose only preparation contained a low (< 50
micrograms ethinyl estradiol or < 80 micrograms mestranol) (OR 0.6, 95%
CI 0.3-1.1) and high (OR 0.8, 95% CI 0.5-1.2) estrogen dose. CONCLUSION:
While our results are limited in their statistical precision and by the
inability of many subjects to recall the brands of oral contraceptives
that they took, they suggest that the newer, low-estrogen-dose oral
contraceptives confer a benefit regarding ovarian cancer risk similar to
that conferred by earlier, high-estrogen-dose formulations.
2
UI - 11962261
AU - Fleischauer AT; Olson SH; Mignone L; Simonsen N; Caputo TA; Harlap S
TI -
Dietary antioxidants, supplements, and risk of epithelial ovarian
cancer.
SO - Nutr Cancer 2001;40(2):92-8
AD - Dept. of Epidemiology, CB 7435, School of Public Health, University of
North Carolina, Chapel Hill, NC 27599, USA.
Several studies of dietary and serum antioxidant micronutrients
(vitamins A, C, and E and beta-carotene) suggest that higher levels may
be protective for ovarian cancer. None of these has examined
supplements. We used a food frequency questionnaire and additional
questions on supplements to study 168 histologically confirmed
epithelial ovarian cancer cases, 159 community controls, and 92
hospital-based controls. Antioxidant consumption from diet or
supplements was calculated in milligrams or international units per day.
In multivariate analyses using only community controls, the highest
levels of intake of vitamins C and E from supplements were protective:
odds ratio (OR) = 0.40 [95% confidence interval (CI) = 0.21-0.78] and OR
= 0.33 (95% CI = 0.18-0.60), respectively. Consumption of antioxidants
from diet was unrelated to risk. In analyses combining antioxidant
intake from diet and supplements, vitamins C (> 363 mg/day) and E (> 75
mg/day) were associated with reduced risks: OR = 0.45 (95% CI =
0.22-0.91) and OR = 0.44 (95% CI = 0.21-0.94), respectively. Results
were similar, with some attenuation toward the null, in analyses
combining both control groups. The levels of vitamins C and E associated
with the protective effect were well above the current US Recommended
Dietary Allowances. These findings support the hypothesis that
antioxidant vitamins C and E from supplements are related to a reduced
risk of ovarian cancer.
3
UI - 12172980
AU - Minko T; Paranjpe PV; Qiu B; Lalloo A; Won R; Stein S; Sinko PJ
TI -
Enhancing the anticancer efficacy of camptothecin using biotinylated
poly(ethylene glycol) conjugates in sensitive and multidrug-resistant
human ovarian carcinoma cells.
SO - Cancer Chemother Pharmacol 2002 Aug;50(2):143-50
AD - Center for Biomaterials, 610 Taylor Road, Piscataway, NJ 08854, USA.
BACKGROUND: Camptothecin (CPT) is an anticancer agent that kills cells
by converting DNA topoisomerase I into a DNA-damaging agent. Although
CPT and its derivatives are now being used to treat tumors in a variety
of clinical protocols, the low water solubility of the drug and its
unique pharmacodynamics and reactivity in vivo limit its delivery to
cancer cells. To increase the anticancer efficacy of CPT a special drug
delivery system is needed. PURPOSE: To synthesize a novel
camptothecin-poly(ethylene glycol) conjugate (CPT-PEG) which includes
biotin as a moiety to enhance nonspecific and/or targeted uptake via the
sodium-dependent multivitamin transporter (SMVT) and to evaluate its
anticancer activity and apoptosis induction. METHODS: CPT-PEG and
CPT-PEG-biotin conjugates were synthesized and studied in vitro in A2780
sensitive and A2780/AD multidrug-resistant human ovarian carcinoma
cells. Cytotoxicity, apoptosis induction, expression of genes encoding
BCL-2 and apoptotic protease-activating factor 1 (APAF-1) proteins and
caspases 3 and 9 as well as caspase activity were measured.RESULTS. We
found that the conjugation of CPT with a simple linear PEG polymer led
to a more than 12-fold enhancement of CPT toxicity in both sensitive and
multidrug-resistant cells. Biotinylation of the PEG led to a further
increase in CPT toxicity (5.2 times in sensitive and 2.1 times in
multidrug-resistant cells) compared to the nonbiotinylated CPT-PEG
conjugate. As a result, the cytotoxicity of the CPT-PEG-biotin conjugate
increased more than 60 times in sensitive and almost 30 times in
resistant cells, probably by enhancing nonspecific passive and/or
SMVT-mediated uptake. In contrast, the same amounts of PEG and
PEG-biotin conjugates without CPT did not induce cell death in either
sensitive or resistant cells. Further analysis showed that the
biotinylated CPT-PEG conjugate induced apoptosis more significantly than
the same equivalent concentrations of free CPT or nonbiotinylated
CPT-PEG. The enhancement of proapoptotic activity was achieved by the
overexpression of genes encoding the APAF-1, and caspases 3 and 9,
increasing caspase activity and simultaneously downregulating the BCL-2
gene. CONCLUSIONS: The results obtained demonstrate that the binding of
CPT to PEG/PEG-biotin polymers increases its cytotoxicity, ability to
induce apoptosis by the activation of caspase-dependent cell death
signaling pathway and simultaneous suppression of antiapoptotic cellular
defense. This suggests that the targeting approach utilizing
transporters such as SMVT may substantially improve the delivery of CPT
and its anticancer activity by enhancing cellular permeability and
possibly retention of CPT.
4
UI - 12240546
AU - Thames HD; Petersen C; Petersen S; Nieder C; Baumann M
TI -
Immunohistochemically detected p53 mutations in epithelial tumors and
results of treatment with chemotherapy and radiotherapy. A
treatment-specific overview of the clinical data.
SO - Strahlenther Onkol 2002 Aug;178(8):411-21
AD - Department of Biomathematics, University of Texas M.D. Anderson Cancer
Center, Houston, TX, USA.
BACKGROUND: The aim was to ascertain whether many hundreds of clinical
reports over the last decade are consistent with the prediction of a
poorer outcome in cancer patients with p53 abnormalities treated with
cytotoxic drugs and radiation. MATERIAL AND METHOD: There are 301
studies on the influence of p53 overexpression published through summer
2000, in which chemotherapy or radiotherapy was used alone or in
combination with surgery. From 45 reports meeting stringent selection
rules, comparison groups are identified in whom the same measure of
outcome was reported for the same treatment applied to the same tumor,
with results corrected for important prognostic factors. Metaanalysis
techniques are then applied to the comparison groups. Attention was
limited to reports using immunohistochemical techniques, to form
comparison groups of sufficient size. RESULTS: Four comparison groups
were identified by treatment and endpoint: 1) Stage I-III breast cancer
(surgery and chemotherapy, disease-free survival, seven studies); 2)
stage I-III breast cancer (surgery and chemotherapy, overall survival,
six studies); 3) stage II-IV head and neck cancer (radiotherapy and
chemotherapy, overall survival, five studies); 4) FIGO I-IV ovarian
cancer (surgery and chemotherapy, overall survival, six studies). In the
breast (disease-free survival) and ovarian (overall survival) comparison
groups, the hazard ratio for a deleterious effect of p53 overexpression
was significant or marginally significant, depending on assumed ranges
for unreported hazard ratios in non-significant studies. CONCLUSIONS:
Despite the many caveats related to metaanalysis applied to
retrospective data, high variability of immunohistochemical technique,
etc., a nearly significant negative effect of p53 overexpression on
outcome of treatment with cytotoxic drugs and radiation emerges in the
few studies where heterogeneity can be sufficiently reduced or accounted
for.
5
UI - 12237282
AU - Brose MS; Rebbeck TR; Calzone KA; Stopfer JE; Nathanson KL; Weber BL
TI -
Cancer risk estimates for BRCA1 mutation carriers identified in a risk
evaluation program.
SO - J Natl Cancer Inst 2002 Sep 18;94(18):1365-72
AD - Department of Medicine and Abramson Family Cancer Research Institute,
University of Pennsylvania Cancer Center, Philadelphia 19104, USA.
BACKGROUND: Increasing numbers of BRCA1 mutation carriers are being
identified in cancer risk evaluation programs. However, no estimates of
cancer risk specific to a clinic-based population of mutation carriers
are available. These data are clinically relevant, because estimates
based on families ascertained for linkage studies may overestimate
cancer risk in mutation carriers, and population-based series may
underestimate it. Wide variation in risk estimates from these disparate
ascertainment groups makes counseling in risk evaluation programs
difficult. The purpose of this study was to estimate BRCA1-related
cancer risks for individuals ascertained in a breast cancer risk
evaluation clinic. METHODS: Cumulative observed and age-adjusted cancer
risk estimates were determined by analyzing 483 BRCA1 mutation carriers
in 147 families identified in two academic breast and ovarian cancer
risk evaluation clinics. Cancer risks were computed from the proportion
of individuals diagnosed with cancer during a 10-year age interval from
among the total number of individuals alive and cancer-free at the
beginning of that interval. Age-of-diagnosis comparisons were made using
two-sided Student's t tests. RESULTS: By age 70, female breast cancer
risk was 72.8% (95% confidence interval [CI] = 67.9% to 77.7%) and
ovarian cancer risk was 40.7% (95% CI = 35.7% to 45.6%). The risk for a
second primary breast cancer by age 70 was 40.5% (95% CI = 34.1% to
47.0%). We also identified an increased risk of cancer of the colon
(twofold), pancreas (threefold), stomach (fourfold), and fallopian tube
(120-fold) in BRCA1 mutation carriers as compared with Surveillance,
Epidemiology, and End Results (SEER) Program population-based estimates.
CONCLUSION: The estimates for breast and ovarian cancer risk in BRCA1
mutation carriers is higher than population-based estimates but lower
than estimates based on families ascertained for linkage studies. These
cancer risk estimates may most closely approximate those faced by BRCA1
mutation carriers identified in risk evaluation clinics.
6
UI - 12237285
AU - Hilton JL; Geisler JP; Rathe JA; Hattermann-Zogg MA; DeYoung B; Buller
TI -
RE
Inactivation of BRCA1 and BRCA2 in ovarian cancer.
SO - J Natl Cancer Inst 2002 Sep 18;94(18):1396-406
AD - Department of Obstetrics and Gynecology, Division of Gynecologic
Oncology, Holden Comprehensive Cancer Center, Iowa City, IA, USA.
BACKGROUND: Although BRCA1 and BRCA2 play important roles in hereditary
ovarian cancers, the extent of their role in sporadic ovarian cancers
and their mechanisms of inactivation are not yet well understood. Our
goal was to characterize BRCA2 mutations and mRNA expression in a group
of ovarian tumors previously evaluated for BRCA1 mutations and mRNA
expression. METHODS: The tumors of 92 unrelated women with "ovarian"
cancer (i.e., ovarian, peritoneal, or fallopian tube cancer) were
screened for BRCA2 null mutations using a protein truncation test.
Methylation-specific polymerase chain reaction (PCR) was used to examine
the BRCA2 promoter for hypermethylation in tumors that did not express
BRCA2 mRNA. All statistical tests were two-sided. RESULTS: Nine tumors
had a germline (n = 5) or somatic (n = 4) BRCA2 mutation; each was
associated with loss of heterozygosity. All of the somatic (1445delC,
E880X, 4286del8, and 5783delT) and one of the germline (5984ins4)
mutations were unique to this study. One tumor had somatic mutations in
both BRCA1 and BRCA2. Two tumors are, to our knowledge, the first cases
of germline BRCA2-associated peritoneal cancer. Twelve additional tumors
lacked detectable BRCA2 mRNA, but the BRCA2 promoter was hypermethylated
in only one of them, suggesting that other mechanisms effect
transcriptional silencing of BRCA2. Tumors lacking BRCA1 mRNA were more
likely to lack BRCA2 mRNA than tumors expressing BRCA1 mRNA (P<.001).
Overall, 82% (95% confidence interval [CI] = 74% to 90%) of the tumors
contained alterations in BRCA1, BRCA2, or both genes. Of 41 informative
tumors with some alteration in BRCA2, 36 also had an alteration in
BRCA1. The frequency, but not the mechanism, of BRCA1 or BRCA2
dysfunction in ovarian cancer was independent of family history.
CONCLUSIONS: Multiple mechanisms cause nearly universal dysfunction of
BRCA1 and/or BRCA2 in hereditary and sporadic ovarian carcinoma. Ovarian
cancers with BRCA2 dysfunction often have simultaneous BRCA1
dysfunction.
7
UI - 2348208
AU - Gwinn ML; Lee NC; Rhodes PH; Layde PM; Rubin GL
TI -
Pregnancy, breast feeding, and oral contraceptives and the risk of
epithelial ovarian cancer.
SO - J Clin Epidemiol 1990;43(6):559-68
AD - Division of Reproductive Health, Centers for Disease Control, Atlanta,
GA 30333.
To quantify the effects of cumulative months of pregnancy, breast
feeding, and oral contraceptive use on the risk of developing epithelial
ovarian cancer, the authors used data collected for the Cancer and
Steroid Hormone Study--a multicenter, population-based, case-control
study. Detailed reproductive histories were obtained from 436 women aged
20-54 with epithelial ovarian cancer newly diagnosed between December
random from the same geographic areas. Estimated relative risks of
epithelial ovarian cancer were 0.6 (95% confidence interval (CI)
0.5-0.8) for women who had ever been pregnant, 0.6 (95% CI 0.5-0.8) for
women who had ever breast fed, and 0.5 (95% CI 0.5-0.7) for women who
had ever used oral contraceptives. Logistic regression analysis revealed
a strong trend in decreasing risk of epithelial ovarian cancer with
increasing cumulative months of pregnancy; this effect was less
pronounced in women aged 50-54 than in younger women. In contrast, a
marked reduction in risk was associated with ever having breast fed or
used oral contraceptives, while the decrease in risk from additional
months of either of these exposures was less than that for pregnancy.
8
UI - 1868732
AU - Stanford JL
TI -
Oral contraceptives and neoplasia of the ovary.
SO - Contraception 1991 Jun;43(6):543-56
AD - Fred Hutchinson Cancer Research Center, Program in Epidemiology (MP-474)
Seattle, Washington 98104.
Epidemiologic literature on oral contraceptives in relation to primary
ovarian cancer is reviewed. Compared to women who have never used oral
contraceptives, women who have ever taken oral contraceptives have about
a 30% reduction in risk for epithelial ovarian cancer, and five or more
years of use is associated with a 50% reduction in risk. The protective
effect of oral contraceptives persists for ten or more years after use
is discontinued, and becomes apparent several years after beginning use.
Effects of oral contraceptives are similar for malignant and borderline
malignant epithelial ovarian cancer. Reduced risks among oral
contraceptive users have been observed for all major histologic subtypes
of epithelial ovarian cancer, and for women from developed and
developing countries. Risk estimates for epithelial ovarian cancer in
relation to oral contraceptive use stratified by age at diagnosis or
parity are not uniform across studies. No consistent protective effect
is apparent for non-epithelial ovarian tumors or benign ovarian tumors,
including teratomas and cystadenomas, although limited data are
available on the relationship between oral contraceptives and these
neoplasms. Several areas for future research are described.
9
UI - 1874572
AU - Franceschi S; Parazzini F; Negri E; Booth M; La Vecchia C; Beral V;
TI -
Tzonou A; Trichopoulos D
Pooled analysis of 3 European case-control studies of epithelial ovarian
cancer: III. Oral contraceptive use.
SO - Int J Cancer 1991 Aug 19;49(1):61-5
AD - Epidemiology Unit, Aviano Cancer Center, Italy.
The relationship between use of oral contraceptives (OCs) and other
contraceptive methods and the risk of ovarian cancer was examined in a
combined analysis of 3 hospital-based case-control studies conducted in
Italy, the United Kingdom, and Greece, for a total of 971 ovarian cancer
cases and 2,258 controls under age 65. Compared with never-users, the
combined multivariate relative risk (RR) for ever-users was 0.6 (95%
confidence interval, CI = 0.4-0.8) and the estimates were consistent in
the 3 datasets. The protection was also similar across strata of age and
parity. Considering various measures of OC use, available in the Italian
and British datasets only, the protection conveyed on ovarian cancer
risk increased with the duration of use and persisted in the medium-long
period: the RR in women reporting their last OC use greater than or
equal to 15 years prior to diagnosis was 0.5 (95% CI = 0.2-1.0). The
risks in ever-users were appreciably lower in those women who reported
their first OC use before 25 years of age (RR = 0.3 for first use before
age 25, 0.8 for first use at age 25-34 and 0.7 at 35 years or after).
Such findings emerged similarly from Italian and British data. This
combined analysis, besides offering further quantitative estimates of
the protective effects of OCs on ovarian cancer risk in European
populations, provides useful insights into the time pattern of the
relationship between OC use and ovarian carcinogenesis, suggesting that
the protection persists for 15 years or more after cessation of use and
may be larger for use at younger age.
10
UI - 1877597
AU - Irwin KL; Weiss NS; Lee NC; Peterson HB
TI -
Tubal sterilization, hysterectomy, and the subsequent occurrence of
epithelial ovarian cancer.
SO - Am J Epidemiol 1991 Aug 15;134(4):362-9
AD - Centers for Disease Control, Atlanta, GA.
Several hypotheses predict that tubal sterilization and hysterectomy may
influence a woman's risk of developing ovarian cancer. To examine the
relation between these surgeries and epithelial ovarian cancer, the
authors analyzed data from the Cancer and Steroid Hormone Study, a
case-control study of women aged 20-54 years. Eight population-based
cancer registries in the United States identified women with newly
diagnosed epithelial ovarian cancer during 1980-1982 (n = 494). A
comparison sample of female residents of these eight areas (n = 4,238)
was identified through random digit dialing. Women who had had tubal
sterilization (relative risk (RR) = 0.69, 95% confidence interval (Cl)
0.50-0.95), a hysterectomy only (RR = 0.55, 95% Cl 0.38-0.81), or a
hysterectomy with unilateral oophorectomy (RR = 0.60, 95% Cl 0.31-1.17)
had lower risks of ovarian cancer than did women who had never had any
sterilization surgery. However, the negative associations with tubal
sterilization and hysterectomy only appeared to wane after two decades.
These findings may be partly explained by the screening for occult
ovarian pathology that often accompanies pelvic surgery: Women whose
ovaries screen as "negative" may be temporarily at low risk of being
diagnosed with ovarian cancer. However, because the decreased risks
persisted for so long, it is conceivable that hormonal, mechanical, or
circulatory sequelae of these sterilization procedures may act to lower
ovarian cancer risk.
11
UI - 1897499
AU - Harlow BL; Cramer DW; Geller J; Willett WC; Bell DA; Welch WR
TI -
The influence of lactose consumption on the association of oral
contraceptive use and ovarian cancer risk.
SO - Am J Epidemiol 1991 Sep 1;134(5):445-53
AD - Department of Obstetrics and Gynecology, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA 02115.
The authors investigated the joint effects of diet and oral
contraceptive use on ovarian cancer risk in 194 white women aged 65
years or less with epithelial ovarian cancer and 193 age- and
residence-matched controls in Boston between 1984 and 1987 by using
in-person interviews and self-administered food frequency
questionnaires. Use of oral contraceptives for 3 months or more was
associated with a modest protective effect for ovarian cancer (odds
ratio (OR) = 0.7, 95 percent confidence interval (CI) 0.5-1.1). In women
who consumed 11 g or less per day of lactose, use of oral contraceptives
for 3 months or more was associated with a nonsignificant increased risk
(OR = 1.6, 95 percent CI 0.8-3.2). In women who consumed more than 11 g
per day of lactose, use of oral contraceptives for 3 months or more was
associated with a substantially decreased risk of ovarian cancer (OR =
0.3, 95 percent CI 0.1-0.7). Within this group, the strongest
association occurred with more than 4 years of total oral contraceptive
use (OR = 0.2, 95 percent CI 0.1-0.6) and in those who had more than 2
years of oral contraceptive use after age 30 years (OR = 0.1, 95 percent
CI 0.03-0.4). These results suggest that, with respect to ovarian
cancer, lactose users may be the most likely to benefit from oral
contraceptive use and that the benefit may be strongest when oral
contraceptive use occurs after age 30 years.
12
UI - 1800425
AU - Parazzini F; Restelli C; La Vecchia C; Negri E; Chiari S; Maggi R;
TI -
Mangioni C
Risk factors for epithelial ovarian tumours of borderline malignancy.
SO - Int J Epidemiol 1991 Dec;20(4):871-7
AD - Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
A case-control study was conducted on 91 cases with
histologically-confirmed borderline ovarian tumours and 237 control
subjects in hospital for acute non-gynaecological, hormonal or
neoplastic disease. Women reporting three or more births, compared to
nulliparae, had a relative risk (RR) estimate of 0.6, but this finding
was not statistically significant (95% confidence interval (CI):
0.2-1.4). The risk of borderline tumours increased, although not
significantly, with later age at first birth: compared to women
reporting first birth at age 24 or before, the RRs were 1.3 and 1.7 in
those reporting respectively their first birth at age 25-29 and 30 years
or more. No significant relationship emerged between borderline ovarian
cancer and age at menarche, menopausal status and lifelong menstrual
pattern. Cases tended to report a later age at menopause than controls,
but the trend in risk was not statistically significant. Nine cases
(9.9%) and 68 controls (24.9%) reported oral contraceptive use: compared
with never users the multivariate RR for ever users was 0.3, and the
risk dropped with duration of use to 0.2 in users for two years or more
(chi 2 (1) trend = 12.70, p less than 0.001). This study provides
epidemiological evidence of a pathogenetic continuum between borderline
and invasive ovarian tumours.
13
UI - 1544753
AU - Chen Y; Wu PC; Lang JH; Ge WJ; Hartge P; Brinton LA
TI -
Risk factors for epithelial ovarian cancer in Beijing, China.
SO - Int J Epidemiol 1992 Feb;21(1):23-9
AD - Department of Obstetrics and Gynaecology, Peking Union Medical College,
Beijing, China.
A study in Beijing, China of 112 pathologically confirmed epithelial
ovarian cancer cases and 224 age-matched community controls enabled
evaluation of risk in relation to reproductive, medical, familial, and
selected lifestyle factors. An inverse relationship was observed between
the number of full-term pregnancies and ovarian cancer risk. Compared to
nulliparous women, subjects with one, two, or three full-term
pregnancies were at 50%, 70%, or 90% reduced risks, respectively (P for
trend less than 0.01). A positive correlation was found between the
number of ovulatory years and risk, with a 2.6-fold increased risk for
women with 30 or more compared to less than 10 ovulatory years (P for
trend less than 0.01). Infertility, as estimated in various ways, was
also found to be an important risk factor. When parity was taken into
account, age at first pregnancy was not related to ovarian cancer risk.
No protective effect was associated with mumps virus infection. In
contrast, risk increased significantly as serum mumps virus antibody
titres increased (P for trend less than 0.01). An elevated risk was
found in women with a history of long-term (greater than 3 months)
application of talc-containing dusting powder to the lower abdomen and
perineum (Relative risk 3.9, 95% confidence interval: 0.9-10.63). These
findings suggest that Chinese women have risk factors similar to those
of occidental women.
14
UI - 1559340
AU - Petitti DB; Porterfield D
TI -
Worldwide variations in the lifetime probability of reproductive cancer
in women: implications of best-case, worst-case, and likely-case
assumptions about the effect of oral contraceptive use.
SO - Contraception 1992 Feb;45(2):93-104
AD - Department of Family and Community Medicine, University of California,
San Francisco School of Medicine 94143.
Cancer incidence in countries representative of three patterns of
reproductive cancer and age-specific mortality was used to estimate the
effect of oral contraceptive use on the lifetime probability of
reproductive cancer under three sets of assumptions about the effects of
oral contraceptives. Under the set of assumptions considered likely,
oral contraceptives were estimated to reduce or increase only slightly
the lifetime probability of any reproductive cancer in each setting.
Under worst-case assumptions, oral contraceptives were estimated to
increase the lifetime probability of reproductive cancer only modestly
in settings with low cancer rates and in settings with high rates of
breast, ovarian, and endometrial cancer, but it might have a large
impact on lifetime probability of reproductive cancer in settings with
high cervical cancer rates. Under best-case assumptions, oral
contraceptives were estimated to decrease the lifetime probability of
reproductive cancer in each setting; this reduction was estimated to be
greatest in settings where endometrial and ovarian cancer incidence are
high.
15
UI - 1622631
AU - Spicer DV; Pike MC
TI -
The prevention of breast cancer through reduced ovarian steroid
exposure.
SO - Acta Oncol 1992;31(2):167-74
AD - University of Southern California School of Medicine, Department of
Preventive Medicine, Los Angeles 90033-9987.
Analysis of epidemiologic data on cancers of the breast, ovary and
endometrium; the effects of endogenous hormones on cell proliferation;
and current carcinogenesis concepts, suggest that hormonal
contraceptives can be developed that will reduce lifetime risk of all 3
cancers. The 'unopposed-estrogen hypothesis' accounts for endometrial
cancer risk factors. Ovarian cancer risk is closely related to the total
frequency of ovulation. The risk of breast cancer can be explained by an
'estrogen-plus-progestogen hypothesis'. On the basis of this analysis an
hormonal contraceptive regimen has been developed consisting of a
gonadotropin-releasing hormone agonist (GnRHA) plus continuous low-dose
add-back estrogen and a short course of progestogen every fourth month.
The total dose of add-back estrogen is estimated to be approximately 38%
that in present-day low-dose combination-type oral contraceptives
(COCs). The total dose of progestogen is approximately 15% that in COCs.
This regimen prevents ovulation and should thus reduce ovarian cancer
risk. It also reduces the exposure of the endometrium to unopposed
estrogen, and the exposure of the breast to estrogen-plus-progestogen.
It is estimated that use of such a regimen for 10 years will only reduce
lifetime risk of endometrial cancer by one-sixth, but lifetime risk of
ovarian cancer is estimated to be reduced by two-thirds, and lifetime
risk of breast cancer is estimated to be reduced by one-half.
16
UI - 1294683
AU - Badawy YA; Bayoumi DM
TI -
An epidemiologic study of ovarian cancer. Part 11: Oral contraceptive
use and menstrual events.
SO - J Egypt Public Health Assoc 1992;67(5-6):579-91
AD - Department of Community Medicine, Faculty of Medicine, University of
Alexandria, Egypt.
This work was conducted to investigate the potential risk factors which
may contribute to the development of ovarian cancer. A retrospective
analysis was adopted where 52 ovarian cancer cases and an equal number
of a control group were obtained from the Western region of Saudi
Arabia. This case-control study confirms that oral contraceptive use
protects against the onset of ovarian cancer and that the decrease in
the risk of the development of this disease is also directly related to
the duration of use. Additionally, the study revealed a positive
association between both age at menopause and hot flashes and the
relative risk of ovarian cancer. On the contrary, age at menarche and
premenstrual tension have been shown in this study to have no role as a
risk factor in the development of ovarian cancer.
17
UI - 7304575
AU - Hildreth NG; Kelsey JL; LiVolsi VA; Fischer DB; Holford TR; Mostow ED;
TI -
Schwartz PE; White C
An epidemiologic study of epithelial carcinoma of the ovary.
SO - Am J Epidemiol 1981 Sep;114(3):398-405
A case-control study to identify risk factors for epithelial ovarian
cancer was undertaken among women in the age group 45-74 years who had
been admitted to seven hospitals in Connecticut between July, 1977, and
March, 1979. Characteristics that were found to increase the risk of
epithelial ovarian cancer included being white, never having been
pregnant, having a late age at menopause, having a family history of
cancer of the ovary or endometrium, and having a long estimated number
of years of ovulation. Prior use of post-menopausal estrogens did not
alter the risk for epithelial ovarian cancer, but there was some
indication that oral contraceptives protect against ovarian cancer.
Women with ovarian cancer were somewhat more likely to have had a
history of an underactive thyroid and were somewhat less likely to have
had a history of an overactive thyroid than controls, although these
trends were not statistically significant.
18
UI - 7045417
AU - Rosenberg L; Shapiro S; Slone D; Kaufman DW; Helmrich SP; Miettinen OS;
TI -
Stolley PD; Rosenshein NB; Schottenfeld D; Engle RL Jr
Epithelial ovarian cancer and combination oral contraceptives.
SO - JAMA 1982 Jun 18;247(23):3210-2
The risk of epithelial ovarian cancer in relation to the use of
combination oral contraceptives was evaluated in a case-control study of
women younger than 60 years. Combination oral contraceptives were used
by 35 (26%) of 136 cases and 187 (35%) of 539 controls. The relative
risk estimate for combination oral contraceptive use was 0.6 (95%
confidence interval, 0.4 to 0.9). The reduction in risk appeared to
persist for as long as ten years after use had ceased and to be greater
for longer durations of use, but these results were not statistically
significant. The findings were not explained by parity or by other
identified potential confounding factors. The results suggest that the
use of combination oral contraceptives protects against epithelial
ovarian cancer.
19
UI - 7121514
AU - Cramer DW; Hutchison GB; Welch WR; Scully RE; Knapp RC
TI -
Factors affecting the association of oral contraceptives and ovarian
cancer.
SO - N Engl J Med 1982 Oct 21;307(17):1047-51
We investigated the relation between epithelial ovarian cancer and the
use of oral contraceptives in a case-control study of 144 white women
under the age of 60 who had ovarian cancer and 139 white women under 60
who were selected from the general population. We observed a decreased
risk for ovarian cancer associated with the use of oral contraceptives
in subjects 40 through 59 years of age at the time of the study. The
relative risk, adjusted for parity, was 0.11, with 95 per cent
confidence limits of 0.04 to 0.33. In contrast to the findings in older
women, a decreased risk for ovarian cancer associated with
oral-contraceptive use was not found in women under 40. In this group,
the adjusted relative risk associated with any use of oral
contraceptives was 1.98, with 95 per cent confidence limits of 0.74 to
5.27. The lowest risk for ovarian cancer associated with the use of oral
contraceptives was observed in older parous subjects and in women who
had discontinued use more than 10 years previously.
20
UI - 3000668
AU - Jolles CJ
TI -
Ovarian cancer: histogenetic classification, histologic grading,
diagnosis, staging, and epidemiology.
SO - Clin Obstet Gynecol 1985 Dec;28(4):787-99
21
UI - 6762965
AU - Bettochi S; Restaino A; Lucisano F; Orlando E; Ferreri R; Ierardi GM;
TI -
Selvaggi L
Epidemiological factors and prophylaxis of ovarian tumors.
SO - Eur J Gynaecol Oncol 1982;3(3):192-205
22
UI - 6681935
AU - Risch HA; Weiss NS; Lyon JL; Daling JR; Liff JM
TI -
Events of reproductive life and the incidence of epithelial ovarian
cancer.
SO - Am J Epidemiol 1983 Feb;117(2):128-39
Women resident in six counties of Washington and Utah for whom diagnoses
of epithelial ovarian cancer were made during 1975-1979 were interviewed
concerning their menstrual, reproductive and medical histories. For
comparison, interviews were also obtained from a random sample of women
living in the same countries. Logistic regression methods were used, and
histories of childbearing, miscarriages, lactation, and (in Washington)
usage of oral contraceptives were found to be associated with decreased
risk of ovarian cancer; the estimated relative risks were, respectively,
0.88 per pregnancy (i.e., 0.88(2) for two pregnancies, etc.) (p =
0.016), 0.82 per miscarriage (p = 0.049), 0.79 per year of lactation (p
= 0.034), and 0.89 per year of oral contraception (p = 0.009). In
addition, it was observed that the magnitudes of the diminished risks
from these exposures substantially exceeded those which would have been
expected solely on the basis of their inhibition of ovulation (X2(5) =
21.5, p = 0.0006). On the other hand, the lack of association found
between the occurrence of ovarian cancer and either total dose or total
time of exposure to noncontraceptive estrogens, or with a history of
usage of thyroid medications, suggests that periods of reduced pituitary
gonadotrophin secretion fail to reduce risk of ovarian cancer. Thus,
although pregnancy, lactation and oral contraception appear to offer
some protection against the development of epithelial ovarian cancer,
the reasons remain obscure.
23
UI - 6835277
AU - Casagrande JT; Pike MC; Henderson BE
TI -
Oral contraceptives and ovarian cancer.
SO - N Engl J Med 1983 Apr 7;308(14):843-4
24
UI - 3591776
AU - Franks AL; Lee NC; Kendrick JS; Rubin GL; Layde PM
TI -
Cigarette smoking and the risk of epithelial ovarian cancer.
SO - Am J Epidemiol 1987 Jul;126(1):112-7
Cigarette smoking may affect each of the currently proposed mechanisms
of ovarian carcinogenesis. Whether cigarette smoking has any effect on
the development of ovarian cancer has not been adequately evaluated. To
study this issue, the authors examined data from the Cancer and Steroid
Hormone Study, a multicenter, case-control study of gynecologic cancers
conducted between December 1, 1980, and December 31, 1982, in eight
geographic areas of the United States. This analysis utilized data on
494 women with newly diagnosed epithelial ovarian cancer and 4,238
population-based control women 20-54 years of age. There was no
association of epithelial ovarian cancer with dose of cigarette smoking,
age smoking started, time since smoking started, or time since smoking
last occurred. Simultaneous adjustment for age, parity, history of oral
contraceptive use, and other potentially confounding factors did not
alter these results.
25
UI - 3605266
AU - Stockwell HG; Lyman GH
TI -
Cigarette smoking and the risk of female reproductive cancer.
SO - Am J Obstet Gynecol 1987 Jul;157(1):35-40
An epidemiologic study was conducted to evaluate the relationship
between cigarette smoking and the risk of breast, endometrial, and
ovarian cancers. Results indicated a clear reduction of risk for
endometrial cancer among women aged 50 years and older who smoke
cigarettes. Risks were significantly reduced among moderate smokers
(odds ratio = 0.6), heavy smokers (odds ratio = 0.4), and former smokers
(odds ratio = 0.6). No association was observed among women under age 50
years. When the relationship between cigarette smoking and breast cancer
was investigated, no statistically significant association between
cigarette smoking and the risk of breast cancer was observed except
among women greater than 50 years who were light smokers only. There was
also a nonstatistically significant increase in risk among younger women
smoking more than two packs of cigarettes a day (odds ratio = 2.0), but
overall there was no evidence of any relationship. Similarly, no
association between ovarian cancer and cigarette smoking was apparent,
although there was a nonsignificant increase in risk among women under
age 50 years who smoked 40 or more cigarettes a day or were exsmokers.
26
UI - 6539067
AU - Nasca PC; Greenwald P; Chorost S; Richart R; Caputo T
TI -
An epidemiologic case-control study of ovarian cancer and reproductive
factors.
SO - Am J Epidemiol 1984 May;119(5):705-13
A population-based case-control study was conducted with 403 white,
ovarian cancer patients, 20-79 years of age, who were diagnosed from
study also included 806 controls who were matched to the cases by age,
race, and county of residence. The contraceptive and reproductive
patterns observed in this study suggest that infertility plays an
important role in determining the relationship between reduced parity
and gravidity and increased ovarian cancer risk. Ovarian cancer patients
were less likely than controls to have ever used nonpermanent birth
control methods (relative risk = 0.63, 95% confidence interval =
0.45-0.89), and they tended to practice contraception less often. A
direct graded-response relationship was observed between ovarian cancer
risk and the number of contraceptive-free years of marriage (chi 2
Linear trend = 5.911, p = 0.02). An inverse graded-response relationship
was observed between gravidity and risk. This relationship persisted
even after contraception was taken into account (chi 2 Linear trend =
13.002, p = 0.0003). Ovarian cancer risk was not found to be associated
with an excess in reported fetal loss.
27
UI - 6488215
AU - Koch M; Starreveld AA; Hill GB; Jenkins H
TI -
The effect of tubal ligation on the incidence of epithelial cancer of
the ovary.
SO - Cancer Detect Prev 1984;7(4):241-5
A retrospective review of 666 women who underwent tubal ligation between
1930 and 1969 in Alberta, Canada, was undertaken to assess the effect of
tubal ligation on the incidence of ovarian cancer. Tubal ligation did
not affect the risk of ulterior ovarian cancer except in women who
underwent tubal ligation between the ages of 20 and 29. These women
showed a slight but statistically significant (p = 0.03) increase in
observed versus expected cases of ovarian cancer.
28
UI - 6209226
AU - Nischan P; Ebeling K
TI -
Oral contraceptives containing chlormadinone acetate and cancer
incidence at selected sites in the German Democratic Republic--a
correlation analysis.
SO - Int J Cancer 1984 Nov 15;34(5):671-4
The use of oral contraceptives containing chlormadinone acetate in 1972
by women of 13 districts (out of 15) of the GDR has been related to the
incidence of cancer of breast, corpus uteri, and ovary during the period
1961 to 1980. Cancer incidence was represented by cohort parameters
showing the risk of the cohorts in relation to each other. No
statistically significant association between the two events was noted.
Although not significant, our data are consistent with an elevated
relative risk for breast cancer of 1.3 and a decreased risk for ovarian
cancer of 0.5.
29
UI - 6368240
AU - La Vecchia C; Franceschi S; Liberati A; Gallus G; Tognoni G
TI -
The clinical relevance of the epidemiology of ovarian cancer.
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