A 57 y.o G3P2 comes into clinic for a routine annual exam. Age of menarche was 14 and LMP was 5 years ago. She has a history of normal pap smears and no personal history of breast, ovarian, or endometrial cancer. She has a maternal aunt who had breast cancer. On examination there is R adnexal fullness. TVUS shows a 6cm mass at the R ovary. Which of the following is NOT a risk factor for ovarian carcinoma?
A. Nulliparity
B. Early menopause
C. Early menarche
D. Increasing age

The risk factors for endometrial cancer vs. ovarian cancer can sound similar and be CONFUSING on tests! Let's break them down a little bit.

Endometrial cancer: think about prolonged exposure to or unopposed estrogen
Risk factors:
1. Nulliparity
2. Late menopause
3. Early menarche
4. Exogenous estrogen
5. Obesity (peripheral conversion)
6. Chronic anovulation
Pathophys: Unopposed estrogen -> endometrial hyperplasia -> precursor for endometrial carcinoma

Ovarian cancer: think about prolonged ovulation and personal/family hx
Risk factors:
1. Late menopause
2. Early menarche
3. Increasing age
4. Family history
5. Personal history of breast cancer
6. White race
Pathophys is less understood!
?Prolonged ovulation -> prolonged "trauma" to ovarian epithelium
?Genetics -> increased risk

Answer:
B. Early menopause