Published: 2018-10-25

Epidemiology of ovarian cancer in Assiut Governorate, Egypt

Mahmoud Ahmed Gharib, Mahmoud Hussein El-Shoeiby, Nagy Mohammed Metwally, Yostina Maher Rashid


Background: The aim of this study is to assess ovarian cancer epidemiology and detect its prognostic factors in Assuit, Egypt.

Methods: This retrospective study was performed between January 2010 and December 2015, on all cases attending to Obstetrics and Gynecology Outpatient Clinic in all central hospitals in Assiut. 378 females (≥40 years old) came to Obstetrics and Gynecology Outpatient Clinic from January 2010 to December 2015. Inclusion criteria: All females (≥40 years old), history of current acute or chronic pelvic pain, mass; fixed, hard consistency, history of previous similar condition.

Results: Mean age for whole ovarian cancer cases in this study was 56.44±10.08 (range, 40-85). Nulliparity was found in one case (0.3%), while multiparity was found in 252 cases (66.7%). Grand multiparity was found in 113 cases (29.9%). Twelve cases (3.2%) were virgin. Vaginal ultrasound can find all ovarian cancer cases. Regarding the serum levels of the tumor biomarker, CA-125, the average level of CA-125 is 300-1000 U/ml with 34.9% of cases had readings below to 300-1000 U/ml and 6.1% of cases had readings above to this average level. Regarding treatment, treatment combining surgery with chemotherapy was the main line of management in present study (46.3%). About 33.3% of cases underwent surgery, while only 18.3% took the chance of chemotherapy. Eight cases (2.1%) had no treatment.

Conclusions: Epithelial ovarian cancer is a lethal disease. The age incidence of ovarian cancer in present patients is ten years younger than what is re¬ported in US SEER data and other Western countries. CA-125 level and ultrasonography are increasing the rate of suspicious for diagnosis of malignant tumors.


Epidemiology, Ovarian cancer, Ovarian malignancy, Survival

Full Text:



Ahmedin Jemal DV, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, et al. Cancer statistics, 2004. CA A Cancer J Clin. 2004:8-29.

Ibrahim AS, Seif-Eldin IA, Ismail K, Hablas A, Hussein H, Elhamzawy H. Cancer in Egypt, Gharbiah: Triennial Report of 2000-2002, Gharbiah Population-based Cancer Registry. Cairo: Middle East Cancer Consortium. 2007.

Egypt National Cancer Registry, Aswan Profile: Ministry of Communication and Information Technology. 2008.

Harries M, Gore M. Part I: chemotherapy for epithelial ovarian cancer–treatment at first diagnosis. Lancet Oncol. 2002;3(9):529-36.

Chi DS, Zivanovic O, Palayekar MJ, Eisenhauer EL, Abu-Rustum NR, Sonoda Y, et al. A contemporary analysis of the ability of preoperative serum CA-125 to predict primary cytoreductive outcome in patients with advanced ovarian, tubal and peritoneal carcinoma. Gynecol Oncol. 2009;112(1):6-10.

Mostafa MF, El-etreby N, Awad N. Retrospective analysis evaluating ovarian cancer cases presented at the Clinical Oncology Department, Alexandria University. Alexandria J Med. 2012;48:353-60.

Tekay A, Jouppila P. Controversies in assessment of ovarian tumors with transvaginal color Doppler ultrasound. Actu Obstet Gynecol Scand. 1995;75:316-29.

Hegazi RA, Wahab KA, Nahas WE, Mosbah M, Refky B. Epidemiological and pathological correlates of postoperative mortality of patients with ovarian cancer. Surgery Curr Res. 2013;3(126):2161-76.

Alsop K, Fereday S, Meldrum C. BRCA mutation frequency and patterns of treatment response in BRCA mutation–positive women with ovarian cancer: a report from the Australian Ovarian Cancer Study Group. J Clin Oncol. 2012;30(21):2654-63.

Elattar I. Cancer in the Arab World: Magnitude of the problem. In The 132nd annual meeting. UICC. 2004;21(25):35-6.

Dey S, Hablas A, Seifeldin IA, Ismail K, Ramadan M, El‐Hamzawy H, et al. Urban–rural differences of gynaecological malignancies in Egypt (1999-2002). BJOG. 2010;117(3):348-55.

Minelli L, Stracci F, Cassetti T, Canosa A, Scheibel M, Sapia IE, et al. Urban-rural differences in gynaecological cancer occurrence in a central region of Italy: 1978-1982 and 1998-2002. Europ J Gynaecol Oncol. 2007;28(6):468-72.

Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol. 1991;78(1):70-6.

Narod SA, Sun P, Ghadirian P, Lynch H, Isaacs C, Garber J, et al. Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations: a case-control study. Lancet. 2001;357(9267):1467-70.

Curtin NJ. The United Irishmen: Popular Politics in Ulster and Dublin, 1791-1798. Oxford University Press, USA; 1994.

Maggino T, Gadducci A, D'addario V, Pecorelli S, Lissoni A, Stella M, et al. Prospective multicenter study on CA 125 in postmenopausal pelvic masses. Gynecol Oncol. 1994;54(2):117-23.

Tworoger SS, Fairfield KM, Colditz GA, Rosner BA, Hankinson SE. Association of oral contraceptive use, other contraceptive methods, and infertility with ovarian cancer risk. Am J Epidemiol. 2007;166(8):894-901.

DiSilvestro P, Peipert JF, Hogan JW, Granai CO. Prognostic value of clinical variables in ovarian cancer. J Clin Epidemiol. 1997;50(5):501-5.

Mostafa MF, El-etreby N, Awad N. Retrospective analysis evaluating ovarian cancer cases presented at the clinical oncology department, Alexandria University. Alexandria J Med. 2012;48(4):353-60.

Singh PR, Arunachalam IL, Tan BY, Tock EP, Ratnam SS. Ovarian cancer in Oriental women from Singapore: disease pattern and survival. Int Surg. 1990;75(2):115-22.

Eisenkop SM, Friedman RL, Wang HJ. Complete cytoreductive surgery is feasible and maximizes survival in patients with advanced epithelial ovarian cancer: a prospective study. Gynecol Oncol. 1998;69(2):103-8.

Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol. 2002;20(5):1248-59.

Sarwar CM, Siddiqui N, Khokhar RA, Badar F. Epithelial ovarian cancer at a cancer hospital in a developing country. Asian Pac J Cancer Prev. 2006;7(4):595-8.