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Ovarian Cancer in Black Women

Medically Reviewed by Melinda Ratini, DO, MS on July 27, 2022

Non-Hispanic Black women are less likely to get ovarian cancer than women of other races. But for a number of possible reasons, they are more likely to die from the disease than most other groups. Experts think that genes, other health conditions, and lack of access to treatment all affect survival rates. Here’s what we know about racial disparities in ovarian cancer for Black women.

How Common Is Ovarian Cancer in Black Women?

Ovarian cancer makes up around 2.5% of all cancers found in women. But it causes about 5% of cancer deaths in women, because it’s often found late after the cancer has spread.

A little less than 1% of Black women may get ovarian cancer in their lifetime. They have some of the lowest rates of ovarian cancer, compared to other racial/ethnic groups.

Per 100,000 people, here’s a breakdown of how many U.S. women may have ovarian cancer each year:

  • Non-Hispanic white: 12
  • Hispanic: 10.6
  • Non-Hispanic Black: 9.4
  • Asian/Pacific Islander: 9.2

What Kinds of Ovarian Cancer Affect Black Women?

Ovaries are mostly made of three kinds of cells: epithelial, germ, and stromal. Each of these cells can cause a different kind of cancer.

Epithelial tumors form in the tissue around your ovaries. This is the most common kind of ovarian cancer found in women of any race or ethnicity. There are four major types of epithelial ovarian cancer:

  • Serous
  • Endometrioid
  • Clear-cell
  • Mucinous

Black women with epithelial ovarian cancer are diagnosed most often with high-grade serous tumors, the most aggressive kind.

There’s some evidence that Black women are a little more likely to have germ-cell and stromal tumors, compared to other groups. These tend to be less aggressive and easier to treat. But much more research is needed to know how different subtypes of ovarian cancer affect Black women.

What Are Ovarian Cancer Survival and Recurrence Rates for Black Women?

Ovarian cancer survival rates are poorest for non-Hispanic white and Black women. Treatment is better than it used to be. But these advances haven’t equally boosted everyone’s survival rates. “Survival” refers to how long someone lives after a cancer diagnosis.

Between 1975 and 2016, the overall 5-year survival rate for Black women dropped from 44% to 41%. Some research shows some Black women may live less than half the time as others after treatment.

Your chances of living years past your diagnosis are closely tied to the kind of cancer you have and how far it’s spread.

According to data from 2006 to 2012, the 5-year survival rates for ovarian cancer in Black women are:

  • Localized (only in your ovaries), 86%
  • Regional (spread to nearby organs), 58%
  • Distant (spread to other areas of your body), 21%

Ovarian cancer comes back, or recurs, in most people. In fact, it happens to about 70% to 80% of all women even after surgery and chemotherapy. But Black women may live cancer-free for less time than women of other races.

Why Do Black Women Die Sooner From Ovarian Cancer?

Even though they’re diagnosed less often than other groups, Black women have the second-highest chance of dying from ovarian cancer. They also live the shortest amount of time after their diagnosis. These lower survival rates hold true no matter what stage of cancer they have.

Experts aren’t sure why Black women don’t live as long after their diagnosis. There’s ongoing research in this area. Here are some theories scientists are looking into:

Disparities in treatment. Black people are generally less likely to have access to money, education, affordable health insurance, and quality health care. Experts largely blame this on decades of racial discrimination.

Structural racism and other barriers to health care can affect cancer care. They can make it so Black women with ovarian cancer are less likely to get:

  • Social support
  • Timely treatment
  • Care at a high-volume cancer center
  • Optimal surgery and chemotherapy
  • Treatment that follows national cancer guidelines

Black women are also more likely to

  • Get diagnosed with advanced ovarian cancer
  • Receive lower doses of chemotherapy
  • Stop cancer treatment early

Medical mistrust. While Black people tend to have unequal access to care, they’re also less trusting of health professionals and medical treatment. There are well-documented reasons for this.

Other health problems. Black women are diagnosed with certain medical conditions more often than other groups. Public health experts think genes, lifestyle, and the ongoing stress of systemic racism likely all play a part.

Some health issues may boost your odds of ovarian cancer or affect your response to treatment. These include:

  • Obesity
  • High blood pressure
  • Kidney disease
  • Heart disease
  • Diabetes
  • Higher levels of inflammation
  • Low levels of vitamin D

Genetic variants. Genes are passed down through families. And there’s some evidence that Black women are more likely to inherit DNA changes involved in ovarian cancer, including the BRCA1 and BRCA2 gene mutations.

Lack of representation in clinical trials. Black people are underrepresented in clinical trials. That makes it hard to know if new treatments for ovarian cancer will work as well in Black women.

What Are the Symptoms of Ovarian Cancer?

While ovarian cancer is rare, it’s something you might want to talk to your doctor about. They’ll let you know the signs and symptoms to watch for.

You may not have any noticeable changes early on. But some women have symptoms in the months before their diagnosis. These tend to be the same for all races and ethnicities.

Tell your doctor if you have any of the following symptoms that are new, severe, or won’t go away:

  • Swollen belly
  • Belly or pelvic pain
  • Fullness after you eat a small amount of food
  • Weight loss without trying
  • Feeling like you need to pee all the time
  • Peeing more often

You may also get:

  • Tiredness
  • A sick feeling in your stomach
  • Back pain
  • Pain during sex
  • Trouble pooping
  • Changes in your period, including heavy bleeding

If you have non-epithelial tumors, you may have early signs such as:

  • Irregular vaginal bleeding
  • Lack of a regular period
  • Deepening of your voice
  • Extra facial or body hair

See your doctor right away if you have any vaginal bleeding after menopause. Your symptoms might not be caused by ovarian cancer. But no amount of bleeding is normal after your period permanently stops.

How Do You Treat Ovarian Cancer?

Surgery is the main treatment. The goal is to figure out how far your cancer has spread from your ovaries. That’s called staging. Your doctor will also “debulk” your tumor. That’s when they try to remove as much of the cancer as possible.

The next step after surgery depends on how far your cancer has spread. You may need:

  • Chemotherapy
  • Targeted cancer drugs
  • Hormonal treatment
  • Palliative treatment (symptom relief)

Ask your doctor about clinical trials. It’s hard to treat advanced ovarian cancer with current treatments. But you may be able to try new drugs that haven’t been approved yet.

What Is Genetic Testing for Ovarian Cancer?

Up to 20% of ovarian cancers may be passed down through families. That means they’re caused by certain gene changes that came from your parents. The most common ones linked to ovarian cancer are the BRCA1 and BRCA2 mutations.

A genetic counselor can help you decide if these tests are right for you. They’re suggested if you have:

  • Family members who’ve had breast or ovarian cancer
  • A personal history of breast, ovarian, or other female reproductive cancers
  • Known family members with BRCA1 or BRCA2 genes

There are extra steps you and your doctor can take to lower your risk of ovarian cancer if you know there’s a strong chance you’ll get it. That includes surgery to remove your ovaries and fallopian tubes.

Can You Prevent Ovarian Cancer?

Scientists don’t know a lot about why people get ovarian cancer. As a result, there’s not a clear path to prevention. But there are extra steps you can take, especially if you know your risk is high because of your genes. The following are linked to a lower risk of ovarian cancer:

  • Use of birth control pills for 5 or more years
  • Pregnancy and breastfeeding
  • Tubal ligation (getting your fallopian tubes tied)
  • Hysterectomy (getting your uterus taken out)
  • Bilateral salpingo-oophorectomy (getting your ovaries and fallopian tubes taken out)

Ovarian cancer is never your fault. But you can take some healthy steps to lower your odds of it and other health problems. That includes lifestyle changes such as:

Show Sources

SOURCES:

National Organization for Rare Disorders (NORD): “Ovarian Cancer.”

Cancer Causes & Control: “Ovarian Cancer in Women of African Ancestry (OCWAA) consortium: A resource of harmonized data from eight epidemiologic studies of African-American and white women.”

CA: A Cancer Journal for Clinicians: “Ovarian cancer statistics, 2018,” “Cancer statistics for African American/Black People 2022.”

International Journal of Epidemiology: “Racial/ethnic differences in the epidemiology of ovarian cancer: a pooled analysis of 12 case-control studies.”

Clinical Cancer Research: “Racial/Ethnic Disparities in Ovarian Cancer Treatment and Survival.”

National Cancer Institute: “Ovarian Cancer Studies Aim to Reduce Racial Disparities, Improve Outcomes.”

Journal of Ovarian Research: “Racial health disparities in ovarian cancer: not just black and white.”

Annals of Oncology: “Treatment of recurrent ovarian cancer.”

International Journal of Gynecological Cancer: “African American women with advanced-stage ovarian cancer have worse outcomes regardless of treatment type.”

Journal of Oncology Practice: “Factors Associated With Use of a High-Volume Cancer Center by Black Women With Ovarian Cancer.”

Obstetrics & Gynecology: “Racial Disparities in the Treatment of Advanced Epithelial Ovarian Cancer.”

Journal of Health Disparities Research and Practice: “Understanding Medical Mistrust in Black Women at Risk of BRCA1 and 2 Mutations.”

American Cancer Society: “What is Ovarian Cancer?” “Signs and Symptoms of Ovarian Cancer,” “Treatment of Invasive Epithelial Ovarian Cancers, by State,” “Surgery for Ovarian Cancer,” “Can Ovarian Cancer Be Prevented?” “Ovarian Cancer Risk Factors.”

CDC: “Take Action to Lower Your Breast and Ovarian Cancer Risk (African American),” “Genetic Testing.”

Cancer: “Psychosocial factors associated with genetic testing status among African American women with ovarian cancer: Results from the African American Cancer Epidemiology Study.”

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