By Mosope Ososanya. Freelance Health Writer and DLHA volunteer. With medical review and editorial support by the DLHA Team
African women.face more challenges with ovarian cancer diagnosis and care.
Ovarian cancer is caused by abnormal changes (mutation) in the DNA of cells in the ovaries–a female reproductive organ, causing them to multiply rapidly and abnormally. DNA is a basic component of cells of the body that carries genetic information in almost all living organisms.
Ovarian cancer is the 18th most common cancer in the world, the 7th most common cancer among women, and the 8th most common cause of cancer-related deaths among women.
Older women or women with a family history of cancer are at a higher risk.
The rate of ovarian cancer globally has reduced significantly in the last 20 years.  Despite the global reduction, recent trends suggest a rise espcially in Africa, with the possibility of figures doubling by 2040.
By 2040, ovarian cancer cases have been predicted to increase by 42% globally and by 86% in Africa alone. 
As the number of ovarian cancer cases increases, thedeath rate also increases. As of 2020, 17,008 women had died in Africa due to ovarian cancer. The ovarian cancer death toll is predicted to increase by 51% in the world and 92.3% in Africa by 2040.
This means that by 2040, around 15,694 more women could be dead, almost double the present figures.
This leads to the worrisome question "Is an ovarian cancer diagnosis a death sentence for women in Africa?"
This article explores the life expectancy of people who are diagnosed with ovarian cancer in Africa; the stages and treatment options for ovarian cancer; and the challenges of diagnosing ovarian cancer in Africa.
As the name implies ovarian cancer begins at the ovaries (the organ that releases eggs in the female reproductive system). Ovarian cancer happens when there is a rapid and abnormal growth of cells in the ovaries causing a mass of cancerous cells or tumors to form.
The major cause of ovarian cancer is unknown, however, certain factors may increase a woman's chances of getting ovarian cancer.
These risk factors include:
Studies have found that women who use birth control pills or contraceptives for over 5 years have a lower risk of ovarian cancer.[7. 8]
Just like several cancers, ovarian cancer usually doesn't show signs or symptoms at its early stage. However, if symptoms occur they are usually nonspecific and mimic other medical conditions such as ovarian cysts, irritable bowel syndrome (IBS), or a normal menstrual cycle.
Symptoms may include:
Despite not been specific for ovarian cancer, if you have any of the above symptoms and are worried about it, visit with your doctor to get a checkup.
Your doctor would ask you about your complaints, how long you have had it, if you have a family history of similar complaints, and many more questions.
A physical examination would then be performed on you with special attention on the lower of your abdomen and reproductive organs in the pelvis.
In addition, your doctor would usually carry out some additional tests to confirm the diagnosis and to check how far the cancer may have spread.
Examples of the tests include:
Pelvic Exam: The doctor inserts a finger or two into your vagina and uses another hand to press the abdomen lightly and feel for organs in the lower abdomen and pelvic areas.
Blood Test: A complete blood profile may be checked in addition to measurement of the amount of CA-125 protein in the blood. Most women who have been diagnosed with ovarian cancer have shown high levels of CA-125 protein. If they have also been having irregular menstrual bleeding, their blood profile would likely be abnormal.
Imaging Test: Several tests that show the image and structure of the ovaries and other reproductive organs are also done to diagnose ovarian cancer. They include a CT scan or a transvaginal ultrasound scan. This latter test is done by putting an ultrasound scanning probe (transducer) into the vagina and recording a picture of your ovaries and other pelvic organs on the screen of a computerised imaging machine.
Laparoscopy: This is a procedure done by using a camera at the end of a tube to look at the ovaries through a small opening in the tummy.
Abdominal Scan: The scanning device is placed over the tummy to get an image of the ovaries.
When results are still unclear, your doctor may recommend other diagnosis techniques like laparotomy and needle biopsy.
Laparotomy: This is a surgical procedure involving opening up the abdomen after you are put to sleep. The procedure is done to remove the ovaries for cancer examination.
Needle Biopsy: This is a procedure in which a thin needle is used to extract a sample of tissue or cells from the ovaries to check for cancer.
The stages of ovarian cancer are determined by how far the cancer cells have spread.
Ovarian cancer is very much treatable. Studies have shown that most women live longer than 5 years after an ovarian cancer diagnosis if it is identified and treated early.
Using a 5-year survival rate, 95% of people diagnosed and treated with Stage I ovarian cancer are likely to survive. 70% from Stage II, 25% from Stage III, and 15% from Stage IV. 
Ovarian Cancer treatment options depend on the stage of the cancer.
Here are a few effective treatment options:
Chemotherapy: These are medications taken to inhibit the growth of, or destroy, rapidly dividing cancerous cells.
Surgeries: Different types of surgeries can be performed to remove the cancer tumors and affected organs to prevent the cancer from spreading further.
Some of these surgeries include:
This is a surgery done to remove the uterus or womb 
This is a surgical procedure done to remove fatty tissues that surround the bowel organs in the abdomen. These fatty tissues (omentum) contain blood and lymph vessels, nerves, and other tissues (lymph nodes) that maintain fluid balance and protect the body from infections. Unfortunately, the omentum also is a channel for the spread of ovarian cancer to several bowel organs and the rest of the body.
This is a surgery done to remove the ovaries and the fallopian tube.
This task is done during laparotomy and it involves removal of some lymph nodes in the lower belly and below (abdomen and pelvis) for evidence of ovarian cancer spread so that proper staging of the cancer can be done.
This is a surgical procedure done by opening the abdomen through a cut in the abdominal walls to diagnose diseases of the abdomen and remove organs as may be needed as part of treatment.
Since ovarian cancer affects mostly older women who have undergone menopause, the removal of the uterus and other reproductive organs may be an insignificant issue in preventing the spread of cancer cells. It is advisable to discuss your concerns with your healthcare provider, as they will assess and recommend the most suitable treatment.
In 2020, over 24,263 women had been diagnosed with ovarian cancer in Africa. Studies indicate that this may increase by 86% with a doubling in the death toll by 2040.
The major cause of the rise in ovarian cancer death in Africa is because of late diagnosis. Late-stage diagnosis significantly impacts the survival rate of ovarian cancer patients. If ovarian cancer is identified at its early stage, proper treatment can be given to prevent the spread and the victim may have a better chance at survival.
The factors contributing to the late diagnosis of ovarian cancer in Africa are challenges that are not peculiar to this disease alone. They run across many other non-communicable diseases, including stroke, hypertension, heart attack, etc.
Here are some of those challenges:
Limited access to diagnostics tools such as Imaging and biomarker tests; and a shortage of skilled healthcare professionals especially in remote areas in Africa can hinder the early detection of ovarian cancer.
Women with lower socioeconomic status often face barriers to accessing quality healthcare leading to delays in diagnosis and treatment of ovarian cancer. Financial constraints and lack of health insurance contribute to the problem.
Early diagnosis of ovarian cancer is affected by the lack of awareness of its symptoms. Many women in Africa are ignorant of the symptoms and signs of ovarian cancer. When they experience these symptoms, they may turn to Traditional medicine or spiritual and at-home care.
Cultural stigma, traditional beliefs, and societal norms influence ovarian cancer outcomes in Africa. The common societal perceptions of women's health and the stigma attached to discussing reproductive issues may prevent women from speaking up or seeking medical help promptly.
Governments and public health administrators in different African countries need to work together with diverse stakeholders in health to co-produce effective solutions in the areas suggested below.
- Conduct awareness campaigns to educate women about the symptoms of ovarian cancer.
- Emphasize the importance of early diagnosis through regular health check-ups.
- Establish support groups to share experiences and information.
- Organize regular community health outreach programs in rural communities
- Invest in public health campaigns that specifically target rural areas.
- Implement educational programs in schools and communities to raise awareness.
- Provide incentives for healthcare professionals to work in underserved regions.
- Partner with NGOs for collaborative efforts in spreading awareness.
- Build and upgrade healthcare facilities in remote areas to ensure accessibility.
- Develop mobile health clinics to reach rural communities with limited access for purposes of spreading ovarian cancer awareness.
- Utilize telemedicine for remote consultations and diagnostic support.
- Provide subsidies or financial assistance for diagnostic procedures to reduce economic barriers.
- Upgrade and expand medical facilities with a focus on diagnostic capabilities.
- Ensure availability of essential medical equipment for accurate diagnosis.
- Establish diagnostic centers with trained personnel in areas lacking infrastructure.
- Regularly maintain and update medical equipment for reliability.
Ovarian cancer is a type of cancer that affects the ovaries. It barely shows any symptoms in its early stage and there is currently no specific routine screening for ovarian cancer in women who do not show signs or symptoms.
However, every woman should be on the lookout for the hardly noticeable symptoms of ovarian cancer and consult a medical professional promptly. Your doctor would be able to tell if there is a need for an ovarian cancer diagnostic test which may be done through a transvaginal ultrasound, blood tests, CT scan, or needle biopsy.
Ovarian Cancer diagnosis need not be a death sentence for African women if caught early. The success of treating ovarian cancer depends strongly on early diagnosis. 95% of women diagnosed with Stage I ovarian cancer will survive and live longer than 5 years.
Women across Africa should be educated on ovarian cancer and its symptoms. Awareness should be raised on the importance of early diagnosis and women who are diagnosed with ovarian cancer should be supported all through their recovery journey.
An Ovarian cancer diagnosis should not be a death sentence for African women!
1. World Ovarian Cancer Coalition. Ovarian Cancer Key Stat. [Internet. n.d.] . Accessed November 8, 2023.
2. American Cancer Society. Key Statistics for Ovarian Cancer. Cancer.org. Last revised, October 3, 2023. Accessed November 8, 2023
3. World Ovarian Cancer Coalition. Global Ovarian Cancer Charter Data Briefing. https://worldovariancancercoalition.org/wp-content/uploads/2022/02/Global-Priority_Final.pdf. February 2022. Accessed November 8, 2023
4. Cancer Research UK. Ovarian Cancer Survival Statistics. Cancer Research UK. Last reviewed December 15, 2021. Accessed November 9, 2023.
5. Liotta, M. Why Ovarian Cancer Symptoms Are Easily Missed. Loyola Medicine. 2023. Accessed November 9, 2023.
6. Matulonis, U., Sood, A., Fallowfield, L. et al. Ovarian cancer. Nat Rev Dis Primers 2, 16061 (2016). https://doi.org/10.1038/nrdp.2016.61.
7. La Vecchia, C, and S Franceschi. Oral Contraceptives and Ovarian Cancer. European Journal of Cancer Prevention 8, no. 4 (1999): 297–304.
8. Cristina Bosetti et al. Long-term effects of oral contraceptives on ovarian cancer risk. International Journal of Cancer. Volume 102, Issue 3 p. 262-265 17 September 2002. Accessed November 9, 2023.
9. Rice, M.S., Murphy, M.A. & Tworoger, S.S. Tubal ligation, hysterectomy and ovarian cancer: A meta-analysis. J Ovarian Res 5, 13 (2012). https://doi.org/10.1186/1757-2215-5-13
Published: November 21, 2023
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