Ovarian cancer and asbestos

The asbestos-ovarian-cancer link

In the 2012 update to Monograph 100C, the International Agency for Research on Cancer (IARC) classified asbestos as a Group 1 carcinogen for ovarian cancer, that is, there is sufficient evidence that occupational exposure to asbestos causes ovarian cancer in humans. The classification has been reaffirmed in subsequent reviews.

The link is under-recognised in day-to-day clinical practice compared with mesothelioma and lung cancer. Women who worked in industries with historical asbestos use, textile mills, insulation, munitions, some manufacturing and construction trades, may not have their occupational history considered when an ovarian cancer diagnosis is made.

Latency and diagnosis

As with other asbestos-related cancers, latency is long, typically decades after first exposure. Symptoms of ovarian cancer are non-specific (bloating, pelvic or abdominal pain, urinary changes, appetite loss) and are commonly attributed to more benign conditions. Diagnosis usually involves imaging (ultrasound, CT), the CA-125 blood test, and confirmation by biopsy.

Occupational and secondary exposure

Recognised routes of exposure that have been linked to increased ovarian-cancer risk include:

• Direct occupational asbestos exposure in manufacturing, insulation, textiles, and construction.
• Talc contaminated with asbestos (a historical issue in some cosmetic and industrial-grade talcs).
• Secondary (para-occupational) exposure, e.g., laundering asbestos-contaminated work clothes of a family member.