Anne Ainsworth is 55 and from Wiltshire. She was diagnosed with ovarian cancer in late 2014. Here she blogs about the modern minefield of ‘lifestyle risks’ associated with cancer and how they may or may not be linked to the disease.
After being diagnosed with ovarian cancer I started to read about the possible risk factors and wondered whether they could explain why I developed ovarian cancer. From reading Target Ovarian Cancer’s information pages I am aware that age and family history are the big two risk factors for ovarian cancer. Unfortunately none of us can change these, as much as we might like to!
The more I read about the so called lifestyle risks, which are all too often in the news, the more confusing it seemed; you were more at risk if you had no children, hadn’t breastfed, had early onset and late cessation of periods and of course the ‘talc factor’. It also looked like being tall, having irregular periods when younger and having a BMI greater than 25 puts you at risk. Most of this didn’t apply to me. I suppose what I’m thinking here is that these particular risk factors that you hear about all the time seem a bit random – and, most importantly, it feels like we are getting blamed for getting cancer.
While speaking with other women living with ovarian cancer this seemed a common theme:
“Nothing worse than thinking you might have helped caused your cancer.”
“I for one get annoyed at the continual quotes in the media that lifestyle choices have caused my cancer. Whilst I accept these messages have their place it does nothing for us already diagnosed and living with cancer.”
“There seems to be a need to apportion ‘blame’ for cancer in the media. I hate the thought that people may think I’ve made poor lifestyle choices and caused my cancer.”
I would like to know, did my lifestyle really help cause my cancer, could I have done anything to prevent it, and what is the truth behind all these stories? And as with everything that relies on research it is important to ask, where does this lifestyle research come from? I have certainly never been asked about it.
Dr Simon Newman, Director of Research at Target Ovarian Cancer, has the answers:
We hear a lot in news implying your lifestyle choices may have put you at risk of cancer - and how preventable so many cancers apparently are, if only you had made the right choices. Many of these stories are misleading, misreported or plain wrong.
A direct link between lifestyle choices and causation of a specific cancer does not exist for most cancers, with important exceptions including the proven causation between smoking and lung cancer and working with asbestos and risk of mesothelioma.
Most reports in the media are about associations between lifestyle choices and an increased risk of a cancer and are not proof of causation. These reports are usually based either on large studies asking people to recall multiple lifestyle choices they have made, often going back many years, or on treating cancer cells in a laboratory with high concentrations of a particular chemical; you would be amazed what causes and cures cancer based just on lab experiments.
Where associations rather than causations have been demonstrated, these are often reported in overly dramatic ways. If your risk of a particular cancer is one per cent (4 people in 400) and a retrospective study shows a risk of this cancer among the group with the highest consumption of ice cream was 1.75 per cent (7 people in 400), the report might read “Ice Cream Doubles Your Risk of Cancer”. Yet, even if you did eat lots of ice cream in this very much made up example, in reality you would still have a very low risk of getting that cancer - presuming the data stood up to scrutiny (the study would show that among people who eat lots of ice cream, an extra 3 in 400 would get that cancer).
Coming back to ovarian cancer, a key point to remember is that most cancers will not have a simple single cause and, although an oversimplification, could just be regarded as a chance event. We would estimate four out of 200 women to develop ovarian cancer over their lifetime; the various ‘lifestyle factors’ (talc, HRT, IVF, child bearing, BMI, height) all only alter this small risk very slightly. For example, if all 200 women used talc on their genitals regularly, five rather than four would be expected to develop ovarian cancer, even then the link to talc still remains debated as some large studies have found no link. The risk increase for being obese is about half that suggested for talc and links to irregular periods when younger have not stood up to scrutiny. Even if you had multiple lifestyle risk factors these only impact slightly on your inherent risk of ovarian cancer and in no way could ever be described as causative for ovarian cancer. So whilst ‘lifestyle choices’ can play a small part, the two biggest risk factors for ovarian cancer are in fact age and family history, neither of which are lifestyle choices.
Large studies are always taking place internationally to look for links between lifestyle and all cancers; the recent negative study for talc use arose from following 61,000 random women in the USA recording numerous lifestyle factors over time and seeing who went on to develop different cancers and looking for links. If we become aware of studies in the UK looking for volunteers we will let people know as these studies can sometimes help us understand cancer better.
In summary, please be reassured the vast majority of ovarian cancers are not attributable to any lifestyle factor and no lifestyle factor can be said to be causative. I realise that this is a lot to take in, so please do feel free to get in touch with us if you have any queries at all and see our information about ovarian cancer risk.