Is 37 Years Old a Common Age for Advanced Ovarian Cancer?
No, 37 years old is not a common age for advanced ovarian cancer—ovarian cancer is predominantly a disease of older, postmenopausal women, with over 80% of cases diagnosed in women over 50 years and a median age at diagnosis of 61-63 years. 1, 2
Age Distribution of Ovarian Cancer
Epithelial ovarian cancer, which represents approximately 90% of all ovarian cancers and most commonly presents in advanced stages, has a clear age predilection: 2
- The majority (>80%) of epithelial ovarian cancer cases are diagnosed in women over 50 years of age 1
- The average/median age at diagnosis is 61-63 years 1, 2
- The incidence rate is dramatically lower in younger women: 9.4 per 100,000 for those under 65 compared to 54.8 per 100,000 for those 65 years and older 3
Ovarian Cancer Types in Younger Women
While advanced epithelial ovarian cancer at age 37 is uncommon, certain ovarian cancer subtypes do have a predilection for younger women: 4
Nonepithelial ovarian cancers (which make up less than 10% of all ovarian cancers) are more likely in younger patients: 1
- Germ cell tumors occur more commonly in women between ages 10-30 years 1
- Sex cord stromal tumors can occur in younger women and are more likely to be found at early stage 1
- These nonepithelial cancers generally carry a better prognosis and may be treated with conservative surgeries in reproductive-age women 1
Among epithelial subtypes, low-grade serous carcinoma and mucinous carcinoma may occur in younger women more frequently than high-grade serous carcinoma 4
The Hereditary Exception
The critical exception is hereditary ovarian cancer: 1
- Women with hereditary ovarian cancer (BRCA1/2 mutations) tend to develop the disease approximately 10 years earlier than women with non-hereditary ovarian cancer 1
- BRCA1 mutations confer a 15%-45% lifetime risk of ovarian cancer, while BRCA2 mutations confer a 10%-20% lifetime risk 1
- Twenty percent or more of ovarian cancers are genetically inherited, predominantly linked to BRCA1/2 gene variants 1, 2
- Importantly, 44% of patients with high-grade serous ovarian cancer and a germline BRCA mutation did not report a family history of cancer 1
Clinical Implications
When encountering advanced ovarian cancer in a 37-year-old woman, you should: 1
- Strongly consider genetic testing for BRCA1/2 mutations regardless of family history, as nearly half of BRCA mutation carriers lack a reported family history 1
- Consider Lynch syndrome testing, particularly if the histology is endometrioid or clear-cell carcinoma 1
- Recognize that while uncommon, this presentation is not impossible and warrants the same aggressive treatment approach as in older women 3
Critical pitfall to avoid: Do not dismiss concerning ovarian masses in younger women simply because "ovarian cancer is a disease of older women"—while statistically uncommon, hereditary cases and certain subtypes do occur in this age group and require prompt evaluation. 1, 4