Your assessment indicates you have one or more significant risk factors for ovarian cancer, making your overall risk of developing ovarian cancer high.

Your assessment indicates you have one or more moderate risk factors for ovarian cancer, making your overall risk of developing ovarian cancer moderate.

Your assessment indicates you have no significant or moderate risk factors for ovarian cancer, making your overall risk of developing ovarian cancer average for the general public.

Your risk factors and their significance, according to this assessment, are listed below.

About Risk Factors

Most women with ovarian cancer do not have known risk factors. Still, it is important to know about the medically recognized risk factors. According to the American Cancer Society, several specific factors have been discovered that increase a woman's likelihood of developing one type of ovarian cancer called epithelial ovarian cancer. These risk factors do not apply to other, less common types of ovarian cancer, such as germ cell tumors and stromal tumors. If this assessment shows you have risk factors, you should discuss them with your health care provider. The risk of developing ovarian cancer increases with age. This cancer generally develops after menopause. Although most cases of ovarian cancer are diagnosed in older women, the disease can still occur in younger women.

Early cancers of the ovaries tend to cause symptoms that are relatively vague. They can be caused by many conditions that are not cancer. These symptoms include:

• General abdominal discomfort and/or pain (gas, indigestion, pressure, swelling, bloating, cramps)
• Nausea, diarrhea, constipation, or frequent urination
• Pain during sex
• Feeling of fullness even after a light meal
• Shortness of breath
• Feeling tired all the time
• Abnormal bleeding from the vagina

If you have these symptoms and you have risk factors for ovarian cancer, see your health care provider for a complete evaluation. If your risk is high, your provider may suggest more frequent evaluations. That way, if cancer develops, it can be detected and treated as early as possible. Some exams and tests that your health care provider might do are:

• Pelvic exam: This exam is done to feel the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to find any abnormality in their shape or size. (A Pap test is used to find cancer of the cervix. It is often done along with the pelvic exam, but it is not a reliable way to find or diagnose ovarian cancer.)
• Transvaginal ultrasound: This test uses sound waves to create a picture of the uterus and ovaries to try to determine whether a growth is likely to be a cancer or a fluid-filled cyst.
• CA-125: Blood tests for ovarian cancer may include measuring the amount of CA-125. This is a protein that may be higher in many women with ovarian cancer. (This test is not always accurate because some other diseases can increase the blood levels of CA-125, producing a false positive. Some ovarian cancers may not produce enough CA-125, producing a false negative.)
• Genetic testing: If you have close family members who have had breast or ovarian cancer, your provider may suggest a certain blood test. This test can find out if you have a mutation in the BRCA1 or BRCA2 gene. Mutations in these genes have been linked to increased risk for breast and ovarian cancer.

Because of your age, your immediate risk for developing breast cancer is very low.

Because of your age, your immediate risk for developing breast cancer is low.

Because of your age alone, your immediate risk for developing breast cancer is slightly higher than for a younger woman.

Because of your age, your immediate risk for developing breast cancer is moderate. However, because you have risk factors other than age (listed below), your immediate risk is higher than others in your age group.

Because of your age alone, your immediate risk for developing breast cancer is high.

Because of your age alone, your immediate risk for developing breast cancer is high. The additional risk factors you have reported (listed below) increase that risk further over a same-age person without risk factors.

Age is the greatest risk factor for developing breast cancer. Children rarely develop breast cancer. In fact, the incidence doesn't begin to rise until around age 17, but even then the incidence is low. Beginning about age 45, the risk begins to rise rapidly.

Age is the greatest risk factor for developing breast cancer. Children rarely develop breast cancer. In fact, the incidence doesn't begin to rise until around age 17, but even then the incidence is low. Between the ages of 45 and 65, your immediate risk of developing breast cancer increases, especially for women who have risk factors other than age. According to the American Cancer Society, about 18 percent of breast cancer is diagnosed in women in this age range.

Age is the greatest risk factor for developing breast cancer. Children rarely develop breast cancer. In fact, the incidence doesn't begin to rise until around age 17, but even then the incidence is low. Beyond age 45, your immediate risk of developing breast cancer increases, especially if you have other risk factors. These risk factors, especially if they are significant, will put you at increasingly higher risk as you grow older.

Age is the greatest risk factor for developing breast cancer. At age 65 or older, your risk for breast cancer increases with each passing year. According to the American Cancer Society, about 77 percent of breast cancer diagnoses occur after age 50, with the majority after age 65. Other risk factors, if they are present, become increasingly important in determining the risk of developing breast cancer in women older than 65.

Age is the greatest risk factor for developing breast cancer. At age 65 or older, your risk for breast cancer increases with each passing year. According to the American Cancer Society, about 77 percent of breast cancer diagnoses occur after age 50, with the majority after age 65. Other risk factors become increasingly important in determining the risk of developing breast cancer in women older than 65.

Because you are younger than 17, you have almost no immediate risk of developing breast cancer even if you have other risk factors, listed below. Any risk factors you do have, especially if they are significant, will put you in increasingly higher risk categories as you grow older.

Because you are not yet 45 years old, your immediate risk of developing breast cancer is low even if you have other risk factors, listed below. Any risk factors you do have, especially if they are significant, will put you in increasingly higher risk categories as you grow older.

Your risk factors and their significance, according to this assessment, are listed below.

About risk factors and preventive screening

Some risk factors, such as age and family medical history, cannot be changed. However, others—such as weight, smoking, and alcohol consumption—can be modified. If you have risk factors that are modifiable, you should consider making lifestyle changes to reduce those risks. You should avoid alcohol, quit smoking, lose weight if you need to, and exercise regularly. If you have children, breast-feeding them for several months can reduce your breast cancer risk. After menopause, you should avoid hormone therapy. In addition, a healthy diet and adequate exercise may reduce breast cancer risk.

A large portion of the women with breast cancer have no risk factors. Having risk factors does not automatically mean that you will develop breast cancer. But having risk factors is a good reason to discuss them with your physician and schedule preventing screening.

Whether you have risk factors or not, it is important to follow the national breast cancer screening guidelines. Here are the American Cancer Society's recommendations for screenings:

• The benefits and limitations of mammography vary based on factors like age and personal risk. Experts have different recommendations for mammography. Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every two years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. (A mammogram is an X-ray of breast tissue. The X-ray is taken by compressing the breast firmly between a plastic plate and a cassette that contains special X-ray film.)
• The ACS recommends clinical breast exams (CBEs) at least every three years for all women in their 20s and 30s. The ACS recommends annual CBEs for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.
• The USPSTF does not recommend breast self-exams (BSEs) because evidence suggests BSEs do not lower risk for death from breast cancer. The ACS says BSEs are an option for women 20 and older as a means of familiarizing themselves with their breasts so they can notice changes more easily. Talking with your doctor about the benefits and limitations can help you decide if you should start performing BSEs.
• Women who are at increased risk should talk with their health care provider about whether to start mammograms at a younger age, have additional tests (such as breast ultrasound or MRI), or have more frequent exams.

Based on the information you provided, you have one or more risk factors for cervical cancer. A risk factor is any condition or behavior that increases your likelihood of developing a disease. Having a risk factor does not necessarily mean you will develop a disease, however. Knowing what your risk factors are helps your health care provider schedule appropriate screenings and recommend preventive measures.

For cervical cancer, the primary risk factor is infection with certain high-risk types of HPV or human papillomavirus, which causes genital warts. Other secondary risk factors also come into play. Based on the answers to your assessment, your risk factors, if any, are listed below.

The information you provided suggests that you have none of the common risk factors for cervical cancer covered in this assessment. Your results show the following preventive factors that decrease your likelihood developing cervical cancer by varying degrees:

Understanding risk factors for cervical cancer

The most important risk factor for cervical cancer is being infected with the human papillomavirus (HPV). Most women diagnosed with cervical cancer have this virus. HPV is passed on through skin contact with an infected part of the body, usually on or near the sexual organs, the ACS says. Your risk for getting this virus increases if you have sex at an early age, if you have more than one sexual partner during your lifetime, if your partner has had multiple sex partners, or if you have sex with uncircumcised males.

HPV refers to a group of more than 100 types of viruses that cause genital warts. Only a few of these viruses cause cervical cancer; about half of all cervical cancer cases are caused by only two types, HPV 16 and HPV 18, the ACS says. Yet most women who are infected with these types of HPV don't develop cervical cancer.

HPV infection does not always cause warts or other symptoms, so you can pass it to another person without knowing it. Although condoms protect against many sexually transmitted diseases (STDs), they don't offer total protection against HPV, the ACS says. This is because HPV can be passed on by skin contact with an infected area of the body that can't be covered with a condom. Even when no warts are present, HPV can reside in the skin and be passed on. A vaccine that protects against infection with HPV 16 and 18 is expected to be approved in the near future.

According to the American Cancer Society (ACS), other factors that increase your risk for cervical cancer are:

• HIV infection. HIV, the virus that causes AIDS, damages the body's immune system. This puts a woman at greater risk for HPV infection, which may increase the risk for cervical cancer, the ACS says.
• Chlamydia. Chlamydia is a common sexually transmitted disease with few symptoms. Recent research suggests that a past or current chlamydia infection may put a woman at greater risk for cervical cancer.
• Genital herpes. Some research suggests that infection with HSV-2 in some women may help the human papillomavirus to infect the cervix.
• Family history of cervical cancer or cervical dysplasia. Women whose mother or sisters have had cervical cancer or cervical dysplasia are at greater risk themselves for cervical cancer. It has been suggested by some researchers that some women may not fight off HPV infection as well as others owing to an inherited condition.
• Smoking. Women who smoke are about twice as likely as nonsmokers to get cervical cancer. Tobacco smoke contains many cancer-causing chemicals that are carried throughout the body in the blood. These chemicals have been found in the cervix of women who smoke.
• Poor diet. Women who consume few fruits or vegetables may be at higher risk for cervical cancer.

The importance of screening

The increased use of the Pap test has dramatically reduced deaths from cervical cancer. Pap tests find early cancers or changes in the cells of the cervix that could lead to cancer. Cervical cancer develops slowly, usually taking years to progress from a precancerous condition to cancer. For many women, the precancerous changes will not progress to cancer or will go away without any treatment. Precancerous conditions can be treated, preventing cancer from developing.

The American Congress of Obstetricians and Gynecologists recommends that:

• A woman should have her first Pap test at age 21. Women ages 21 to 29 should be tested every two years.
• Women 30 and older who have had three consecutive normal Pap tests may be screened every three years. Some women should continue to be tested every two years: those whose mothers took diethylstilbestrol (DES) while pregnant; those who have HIV; and those whose immune system has been weakened by an organ transplant, chemotherapy, or chronic steroid use.
• it’s reasonable to discontinue screening after three or more consecutive normal Pap tests and no abnormal results within the last 10 years once a woman turns 65 or 70. Women 70 and older should continue to get regular Pap tests if they have a history of cervical cancer; if their mothers took DES while pregnant; or if they have HIV or a weakened immune system.
• A woman who has had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer testing, unless the surgery was done as a treatment for cervical cancer or a precancerous condition. A woman who has had a hysterectomy that did not remove the cervix should continue to follow the guidelines above.
• Some women incorrectly believe that they do not need a Pap test once they have stopped having children. They should continue with these tests according, to ACS guidelines.

Tips for an accurate Pap test

To make sure your Pap test results are accurate, the ACS says to avoid the following:

• Scheduling your test for a time when you are having your menstrual period.
• Douching within two days (48 hours) of your test.
• Having sexual intercourse within two days (48 hours) of your test.
• Using tampons, vaginal medications, foams, creams, or jellies within two days (48 hours) of your test.

Pap test, pelvic exam: The difference

A pelvic exam is not a Pap test, but both are done during the same office visit. The Pap test is usually done first. For the Pap test, the health care provider inserts an instrument called a speculum into the vagina to hold it open, then gently scrapes or brushes the cervix with another instrument to remove a small number of cells. This sample is sent to the laboratory. During a pelvic exam, a health care provider checks the health of a woman's uterus and ovaries by feeling them through the abdomen. For the exam, the provider inserts two fingers into the vagina and presses to steady the uterus; the other hand pushes on the abdomen to feel the uterus and ovaries. A pelvic exam cannot find cervical cancer in its early stages or abnormal cervical cells.

Treatment of cervical cancer

A health care provider may suggest one of the following treatments for precancerous changes of the cervix or for cancer found only in the outer layer of cells the cervix (cancer that has not invaded deeper tissues):

• Cryosurgery. Abnormal cells in the cervix are killed by freezing them.
• Laser surgery. A laser beam burns off abnormal cells or removes a small piece of tissue for examination.

For more advanced cancers, a cone biopsy may be done first to establish the cancer diagnosis. In a cone biopsy (conization), a cone-shaped piece of tissue is removed from the cervix. Treatment for more advanced cancers may be hysterectomy, internal or external radiation, chemotherapy, or a combination of these.

Your relative risk for developing colorectal cancer is . Your risk level is determined by the highest-level risk factor you have reported. (A risk factor is anything that increases your chance of getting a disease or a condition.) Your risk factors and their relative significance are listed below.

The information you provided suggests that your relative risk for developing colorectal cancer is low. You have none of the common risk factors covered in this assessment. Your results show the following preventive factors that decrease your likelihood developing colorectal cancer by varying degrees:

Moderate risk factors:

• You are years old. Risk increases rapidly starting at age 50.
• You are obese; your BMI is 30 or greater.
• You smoke.
• You consume more than 14 alcoholic drinks a week.
• You consume more than 7 alcoholic drinks a week.
• You have had ulcerative colitis for 10 years or more.
• You have had Crohn's disease for 10 years or more.
• None

Mild risk factors:

• You do not get enough exercise.
• You are overweight (but not obese).
• Your diet is higher in fat than advisable.
• You are a former smoker.
• If female, you have a personal history of breast cancer.
• You have a personal history of ovarian cancer.
• None

Your results also indicate the following preventive factors that decrease your risk of colorectal cancer by varying degrees:

• You are not yet 50 years old.
• You get at least 30 minutes of moderate exercise on most days.
• You have maintained a healthy weight; your BMI is less than 25.
• Your diet is low in fat.
• You are a vegetarian.
• You have never smoked cigarettes.
• You have had a fecal occult blood test within the last year.
• You have had a sigmoidoscopy within the last 5 years.
• You have had a colonoscopy within the last 10 years.

Understanding Risk Factors for Colorectal Cancer

Important risk factors for colorectal cancer include family and personal medical history, especially:

• Family history of colorectal cancer or hereditary colorectal cancer syndromes. Up to 10 percent of people with colorectal cancer have inherited a genetic abnormality tied to this illness.
• Personal history of adenomatous polyps or chronic inflammatory bowel disease. Adenomatous polyps of the colon or rectum are noncancerous growths that may develop into cancer if not treated. Chronic inflammatory bowel disease includes ulcerative colitis and Crohn's disease.

Other factors that increase the risk for colorectal cancer, according to the ACS:

• Being of African-American or Eastern European Jewish descent
• Advancing age: More than 90 percent of people with colorectal cancer are 50 or older.
• Lifestyle choices, particularly, a diet high in fat from animal sources (red meat, processed meat), lack of exercise, and smoking
• Excess alcohol consumption (more than two drinks a day for men and one drink a day for women): Excess alcohol intake independently increases risk; excess alcohol may interfere with folic acid intake, and it may interfere with folate metabolism in the body.
• Obesity, which increases your risk for colorectal cancer
• Having type 2 diabetes, which may also increase your risk

The Importance of Screening

Screening is important for preventing colorectal cancer. Screening can find polyps (growths that can become cancer) and remove them before they turn into cancer, the ACS says. Screening can also find cancer early, when it is highly curable

People who have no other risk factors except advancing age should begin regular screening for colorectal cancer at age 50, according to the ACS and the U.S. Preventive Services Task Force. If you have a family history or other risk factors for colorectal cancer, talk with your health care provider about the need for screening at an earlier age or for more frequent screening. Several screening tests are available, but medical experts differ on which test is better or how often to get screened.

For those who are at least 50 years old and of average risk for colorectal cancer, the ACS recommends:

• A fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year, or
• A flexible sigmoidoscopy every five years, or
• A double-contract barium enema every five years, or
• A colonoscopy every 10 years, or
• A CT colonography (virtual colonoscopy) every five years, or
• A stool DNA test (best interval uncertain)

The ACS recommends that you begin testing at an earlier age or have more frequent screening if you have any of these risk factors:

• A family history of colorectal cancer. If your parent, sibling or child was diagnosed younger than 60, or you have two family members diagnosed at any age.
• A family history of hereditary colorectal cancer syndromes (familial adenomatous polyposis and hereditary nonpolyposis colon cancer).
• A personal history of colorectal cancer or adenomatous polyps.
• A personal history of chronic inflammatory bowel disease.

Description of screening tests

Fecal occult blood test (FOBT). This test can find hidden blood in the feces; blood can indicate the presence of polyps or cancers.

Fecal immunochemical test (FIT). This test is similar to a fecal occult blood test, but it doesn't require any restrictions on diet or medications before the test.

Flexible sigmoidoscopy. A slender, flexible, hollow, lighted tube is inserted through the rectum into the lower part of the colon to look for polyps and cancers. Any small polyp found may be removed; polyps, even those that aren't cancerous, eventually may turn into cancer. Recent research has indicated that this test may not be as effective in women. If you are a woman, talk with your health care provider about having a colonoscopy instead of a sigmoidoscopy.

Colonoscopy. Just as in the sigmoidoscopy, a slender, flexible, hollow, lighted tube is inserted through the rectum into the colon to look for polyps and cancers, but a colonoscope is longer and allows the health care provider to see the entire length of the colon. If a small polyp is found, your provider may remove it; polyps, even those that are not cancerous, eventually may turn into cancer.

Double-contrast barium enema. Barium sulfate, a chalky substance, is used to partially fill and open up the colon. An X-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems. If problems are seen, a colonoscopy will be needed to examine them further.

CT colonography (virtual colonoscopy). This test uses computerized tomography (CT) to examine the colon for polyps or masses using special technology. The images are processed by a computer to make a three-dimensional (3-D) model of the colon. Virtual colonoscopy is noninvasive, although it requires a small tube to be inserted into the rectum to pump air into the colon.

Stool DNA (sDNA). This test can be used to check the stool or fecal matter for specific changes in DNA (the genetic blueprint of each cell) that indicate signs of colorectal cancer. You must save an entire bowel movement and send the sample to a laboratory.

Treatment for Colon Polyps and Colorectal Cancer

If your health care provider finds a precancerous polyp, it can be removed during a colonoscopy. If your provider finds cancer, he or she will recommend one of several treatment options. The three main types of treatment for colorectal cancer are surgery, radiation therapy, and chemotherapy, the ACS says. A newer treatment available is called monoclonal antibodies; this treatment more specifically targets the cancer. Depending on how advanced the cancer is, treatments may be combined or used one after another.

Reducing Your Risk of Colorectal Cancer

You can reduce your risk for colorectal cancer by maintaining a healthy weight and eating a nutritious diet that includes plenty of fruits, vegetables, and whole grains. You should also limit how many high-fat foods you eat. You should quit smoking if you smoke and limit your alcohol consumption. You should also get regular exercise; the ACS recommends at least 30 minutes of moderate physical activity five or more days a week. Boosting your amount of exercise to 45 minutes five or more days a week can further reduce your risk for colorectal cancer.

This information is not intended as a substitute for professional health care. Always consult with a health care provider for advice concerning your health. Only your health care provider can do a thorough disease risk assessment or determine if you have colorectal cancer.