Keywords
Ovarian Cancer, Reproductive Health, Lifestyle, Miscarriage, Pakistan
This article is included in the Oncology gateway.
Ovarian Cancer, Reproductive Health, Lifestyle, Miscarriage, Pakistan
Ovarian cancer is one of the most frequently fatal gynaecologic cancers (Jayson et al., 2014; Tworoger & Huang, 2016). According to the American Institute for Cancer Research report, in 2018 ovarian cancer globally accounted for 3.6% of all forms of cancers and the eighth leading cause of death among women globally (Merritt et al., 2018). Only 46% of ovarian cancer patients survive beyond 5 years (Kathawala et al., 2018). The high mortality associated with ovarian cancer is due to late diagnosis and resistance to treatment, (Carollo et al., 2019; Nunes et al., 2019).
According to a 2018 report by World Cancer Research Fund, the diagnosed cases of ovarian cancer are 295,414. The estimated age-standardized incidence and mortality rates of ovarian cancer in 2018 were 6.6 and 3.9, respectively (Bray et al., 2018) and this number is expected to reach at 434,184 by 2040.
The incidence, prevalence, and mortality of ovarian cancer varies across geographical locations and countries (Coburn et al., 2017). Globally, the highest incidence and mortality for ovarian cancer was reported in Serbia (16.6 and 6.8, respectively) and lowest in Gambia (0.6 and 0.43, respectively); in Europe itself, figures were highest in Serbia and lowest in Ireland (11.4 and 6.4, respectively); in Asia, rates are highest in Brunei (16 and 6.2, respectively) and lowest in Yemen (2.6 & 2.1, respectively) (https://gco.iarc.fr/today/online-analysis-table).
The epidemiological diversity could be linked to different risk factors for ovarian cancer (Hunn & Rodriguez, 2012). Poole et al. (2013) called for identifying modifiable risk factors. Jammal et al. (2017) believe that ovarian cancer prevention can be accomplished with clinical approaches.
The aetiology of ovarian cancer cannot be defined by single mechanism (Terry & Missmer, 2017). Hence understanding of risk factors is important (Webb & Jordan, 2017). Clinical evidence shows that by eliminating and decreasing the risk factors, the ovarian cancer cases can be prevented (Bray et al., 2018). Lifestyle modifications can minimize cancer burden (Song & Giovannucci, 2016).
Ali (2018) noted that knowledge on ovarian cancer might increase survival rate. This can help women at risk of ovarian cancer to take special precautions (Li et al., 2015; Torre et al., 2018); thus, help reduce ovarian cancer risk (Momenimovahed et al., 2019).
Schildkraut et al. (2019) reported obesity and family history of breast cancer to be major risk factors for ovarian cancer and Abbott et al. (2016) reported inadequacy of physical activity to be a risk factor. Gabriel et al. (2019) found the use of talc in genital areas to be a risk factor for ovarian cancer in England. In a Canadian study, Koushik et al. (2017) showed strong inverse association between parity and ovarian cancer. Harris et al. (2017) reported oral contraceptive and family history as the main risk factors in an American population. Lee et al. (2013) showed that consumption of green tea increases ovarian cancer risk in a Chinese population. Other risk factors include infertility (Rasmussen et al., 2017), miscarriages (Moorman et al., 2016) and age at menopause.
Doherty et al. (2017) suggests role of ethnically differing populations. Endpoints must represent the disease agent involved and rely on the quality of life (Wilson et al., 2017). Responsive and timely health care facilities that use relational communication, could enhance women's health experience with ovarian cancer (Jelicic et al., 2019).
The research is now at an advanced stage after a development of a literature review, methodology and preparation of a validated questionnaire. The study will be conducted from July 2020 to December 2020. Data collection will start in July 2020.
This will be a case-control study. The cases will be ovarian cancer patients registered at cancer hospitals in Pakistan. Hospitals are selected based on receiving approval from the hospital administrations. The controls will be recruited from the general population, using random digit dialling of individuals in the vicinity of the selected hospitals, since this was what the participating hospitals wanted. Cases and controls will not be matched. In the analysis, the outcome variables will be corrected for all the variables. We do not have the ability to mitigate many sources of bias as we must comply with the hospital’s’ requirements.
A validated questionnaire (validated by a panel of experts, each with doctorates and many years’ experience in biostatistics, public health and biomedicine) will be used to elicit information on following parameters.
1. Socio demographic characteristics
2. Patient clinical data
3. Diagnostic data
4. Lifestyle factors
5. Reproductive health
Patients’ clinical and diagnostic data will be obtained from the respective hospital registries. Written informed consent will be obtained from all participants with the voluntary decision to participate in the study. Interviews will be conducted with questions relevant to the parameters mentioned above.
Power and Sample Size software was used to calculate sample size. The level of significance and power were set as 0.05 and 80%, respectively. Based on results, the minimum required sample size is 387 for cases and 387 for controls. The figures are rounded up to 400 per group.
Inclusion criteria for cases
• Age 30 to 65
• Confirmed diagnosis of ovarian cancer by hospital or health care facility.
Exclusion criteria for cases
• Cognitively impaired
• Diagnosed with any other form of cancer
The inclusion criteria for control will be, age 30 to 65, healthy and cognitively not impaired; and exclusion criteria will be comorbidities, such as diabetes or cardiovascular disease.
Data will be analysed using SPSS version 25. Qualitative variables will be described as frequencies and percentages, while quantitative variables will be described as means and standard deviations if the variable is normally distributed and as median and interquartile ranges, otherwise. Univariate and multivariate binary logistic regression analyses will be used in testing association between the predictor variables and ovarian cancer. In the univariate analysis, the predictor variables will be tested on at time. The variables that are significant at 0.25 level will be included in the multivariate analysis. Finally, stepwise analysis will be used to determine the significant predictors of ovarian cancer.
No data are associated with this article.
Views | Downloads | |
---|---|---|
F1000Research | - | - |
PubMed Central
Data from PMC are received and updated monthly.
|
- | - |
Is the rationale for, and objectives of, the study clearly described?
Yes
Is the study design appropriate for the research question?
Yes
Are sufficient details of the methods provided to allow replication by others?
Yes
Are the datasets clearly presented in a useable and accessible format?
Not applicable
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Public health, social sciences, research methods.
Is the rationale for, and objectives of, the study clearly described?
Yes
Is the study design appropriate for the research question?
Yes
Are sufficient details of the methods provided to allow replication by others?
Yes
Are the datasets clearly presented in a useable and accessible format?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Public Health
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | ||
---|---|---|
1 | 2 | |
Version 1 04 Aug 20 |
read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Already registered? Sign in
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)