Obesity Can Mask Ovarian Cancer Symptoms in African American Women
Excess abdominal fat in overweight and obese women could interfere with the detection of early symptoms of ovarian cancer, and this may contribute to the higher risk of death from ovarian cancer in African American women compared with white women.1
Ovarian cancer was diagnosed in approximately 22 240 women in 2013 in the United States, and led to death for an estimated 14 030 women in 2013. The 5-year relative survival for all stages of ovarian cancer was 44% for white women and 36% for African American women from 2002 to 2008. The reasons for these differences in survival rates are not understood. Background information explained that African American women are nearly twice as likely to be obese as non-Hispanic white women (59% vs 32%) and that obesity is associated with both ovarian cancer risk and survival.
No effective screening method exists for ovarian cancer. Its symptoms include pelvic or abdominal discomfort, irregular bowel function, and bloating, and these symptoms usually lead to its detection.
This study examined the body mass index (BMI) scores of 326 African American women with invasive epithelial ovarian cancer. The women were interviewed by telephone to gather information on their risk factors and symptoms that led to their diagnoses. The researchers compared the frequency and duration of their symptoms by BMI categories.
Approximately 60% of the women in this study were obese, defined as a BMI greater than 30, and 94% of the study's participants reported that they had experienced at least 1 symptom during the year prior to diagnosis.
Women with the highest BMI scores experienced most symptoms more frequently and for longer duration than did women with lower scores.
“Ovarian cancer is often characterized as a 'silent killer,' yet our study showed that most women experience symptoms months before diagnosis. Although they are nonspecific by nature, these symptoms are what cause the majority of patients to seek medical attention,” concluded the authors.
The authors urged health care providers to be vigilant and to consider ovarian cancer in the differential diagnosis, particularly for obese women with a history of several comorbidities.
1. Erondu CO, Albeerg AJ, Bandera EV, et al. The association between body mass index and presenting symptoms in African American women with ovarian cancer [published online ahead of print February 17, 2016]. J Womens Health. doi:10.1089/jwh.2015.5359.