Why Is Ovarian Cancer Rising Among Younger Women in India?

Ovarian cancer has been considered a disease that affects elderly women for a long time. But in recent years, oncologists across India are noticing a troubling shift as more cases are being diagnosed in women as young as their 40s, and 50s. This change raises an urgent question: why is ovarian cancer rising among younger Indian women?

A 54-year-old woman from Mumbai had no prior medical illnesses. However, she had a family history of ovarian cancer. For months she experienced vague abdominal discomfort and bloating, which she initially ignored. When the pain worsened for her to go for tests, it revealed a large ovarian mass.

Further investigations confirmed high-grade serous ovarian carcinoma at an advanced stage (Stage IIIC). Her tumor marker, CA-125, was extremely high at diagnosis, and genetic testing showed a BRCA1 mutation, placing her in a high-risk category.

Her treating oncologist, Dr Ashish Joshi who is a director and co-founder of M|O|C Cancer Care & research Centre while speaking to our team mentioned that this patient underwent upfront chemotherapy as she had an inoperable cancer upfront. After chemo, she underwent a surgery for the residual cancer. Her post-treatment follow-up scans were free of any evident disease. Dr Joshi further explained that since she had a unique BRCA 1 mutation, she was advised a maintenance treatment with targeted therapy that offers better long-term in such cases.

The case underlines a key fact that early diagnosis and appropriate treatment can save lives, even in advanced disease.

Dr Ashish Joshi highlighted following reasons why we see younger women falling prey to ovarian cancer.

1. Lifestyle Changes and Obesity- Urban Indian women are increasingly affected by obesity and metabolic syndrome. Excess body fat increases estrogen production and inflammation, both of which raise ovarian cancer risk.

2. Hormonal Imbalance and Delayed Childbearing- With more women delaying childbirth or remaining child-free, natural protective factors against ovarian cancer are reduced. Pregnancy and breastfeeding lower cancer risk by reducing ovulatory cycles and longer periods of estrogen stimulation.

3. PCOS and Reproductive Disorders- Polycystic Ovary Syndrome (PCOS) is highly prevalent in younger women which increases the risk of ovarian cancer.

4. Genetic Susceptibility - Alterations in BRCA1 and BRCA2 genes greatly elevate the chances of developing ovarian cancer at an early age. In India, genetic testing remains largely unused, and numerous high-risk women are oblivious until cancer is identified.

5. Environmental and Lifestyle Factors- Dietary changes, stress, exposure to endocrine-disrupting chemicals, and pollution are emerging contributors, especially in rapidly urbanizing cities.

By: Dr Ashish Joshi who is a director and co-founder of M|O|C Cancer Care & research Centre