The research abstract below shows a probable link between chlamydia and ovarian cancer.

Research Summary
Ovarian cancer is a highly lethal disease and its underlying biology is poorly understood. Prophylactic salpingo-oophorectomies in BRCA + women have recently implicated the fimbria as a site of origin for high-grade serous carcinoma and its intraepithelial precursors. This suggests that at least some ovarian cancers, probably the most aggressive ones, may not originate in the ovary itself, but rather may arise in the uterine tubes.

Chronic inflammation is associated with carcinogenesis in several tissues, including liver, esophagogastric junction (cardia), and the uterine cervix. The mechanisms underlying the relationship between inflammation and cancer are complex and involve common pathways, in addition to DNA damage.

A critical source of uterine tube inflammation is infection with Chlamydia trachomatis. We hypothesize that C. trachomatis infection may be involved in chronic tubal inflammation and subsequent fimbrial carcinogenesis. Fimbrial intraepithelial precursors can evolve into high grade serous carcinomas that spread rapidly to the ovarian surface and peritoneum; such tumors may appear to be primary ovarian neoplasia, though in reality being a secondary malignancy. This hypothesis must be further investigated to understand the intracellular signaling pathways involved in Chlamydia infection and its healing, and their relationship to carcinogenesis in order to discover potential therapeutic molecular targets.

If our hypothesis were confirmed, salpingectomy instead of ovariectomy may also become the recommended surgery for high risk women.

for the abstract source —>
Is Chlamydia-infected tubal fimbria the origin of ovarian cancer?

Washington, DC — When counseling patients about preventing sexually transmitted diseases (STDs), it’s important for physicians to ask direct questions about both intercourse and noncoital sexual activity, according to a new Committee Opinion issued today by The American College of Obstetricians and Gynecologists (ACOG).

Noncoital sexual behavior includes mutual masturbation, and oral and anal sex and is common among adults and adolescents. Despite concerns expressed in the popular media about an increase in oral sex among adolescents and young adults, there is no evidence that this is the case. However, research does show that oral sex is much more common among adolescents who have already had vaginal intercourse, suggesting that these sexual activities occur at about the same time and with the same partner.

“Most people, including adolescents, are unlikely to use condoms during oral sex, which places them at risk for acquiring an STD,” said Richard Guido, MD, chair of ACOG’s Committee on Adolescent Health Care, which issued the opinion along with ACOG’s Committee on Gynecologic Practice. “This unlikelihood is partly because of a greater perceived safety compared with intercourse. Although sexual behavior is a sensitive issue to address for both patients and physicians, it’s important to discuss sexuality frankly and without judgment so that we can help our patients fully protect themselves against STDs.”

Risk of getting certain STDs varies depending on the specific disease and the sexual behavior:

• the risk of acquiring HIV through oral sex is less than through vaginal sex
• with receptive anal sex having the highest risk
• Herpes is commonly transmitted through kissing and through oral, vaginal, and anal sex.
• Herpes simplex virus Type 1 (HSV-1), typically associated with oral herpes (ie, “cold sores”), can be transmitted to the genitals through oral sex.
• Herpes simplex virus Type 2 (HSV-2), typically associated with genital herpes, can be transmitted to the mouth through oral sex.
• Nonviral STDs, including gonorrhea, chlamydia, and syphilis, also can be transmitted through noncoital sexual activity.

“Our lesbian and bisexual patients also need be screened for STDs based on the same risk factors as other women,” Dr. Guido noted. “Most lesbians have been sexually active with men at some point. Even without this sexual history, there are some STDs that can be transmitted between two women during sexual activity.”

According to ACOG, physicians should ask more direct questions about a patient’s sexual behavior so that they can provide counseling on ways to lower the risk for STDs. Since most women who engage in noncoital sexual activity are also having intercourse, clinicians need to consider whether these noncoital behaviors add any additional risks to those already posed by intercourse.

Risk-reduction strategies:

• limiting the number of sexual partners,
• STD testing before engaging in sexual activity with a new partner
• correct and consistent use of condoms
• abstinence
• and/or mutual monogamy.

Committee Opinion #417, “Addressing Health Risks of Noncoital Sexual Activity,” is published in the September 2008 issue of Obstetrics & Gynecology.

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These common STDs include human papillomavirus (HPV), chlamydia, herpes simplex virus and trichomoniasis, Forhan said.

Forhan announced the results as part of the CDC’s 2008 National STD Prevention Conference, in Chicago.

“These findings are really giving us a lot of pause about how we provide care to adolescent girls who are sexually active,” said Dr. Elizabeth Alderman, an adolescent medicine specialist at Children’s Hospital at Montefiore in New York City and chairperson of the Executive Committee of the Section of Adolescent Health of the American Academy of Pediatrics. “The numbers are really astonishing.”

Forhan noted that most of the burden of STDs falls on young African-American women. “Among African-American teenagers, about one in two were affected compared to one in five white teens,” she said.

In terms of the racial disparity, “it’s what we’ve always seen, which is very unfortunate,” Alderman said.

In the study, Forhan’s team collected data on 838 girls aged 14 to 19 who took part in the 2003-2004 National Health and Nutrition Examination Survey. The study did not include syphilis, gonorrhea or HIV, as earlier studies found very low prevalence of these diseases in this age group.

HPV and chlamydia are the most common STDs found among teenage girls, Forhan said. “Almost one in five overall had a strain of HPV associated with cervical cancer or genital warts,” she said.

“We need to be screening adolescent girls who are sexually active and providing them with HPV vaccine,” Alderman said. “The recommendations are to screen sexually active girls, but many girls don’t disclose to their health-care provider that they are sexually active, even when asked,” she said.

As for chlamydia, 4 percent of teenaged girls had this STD, Forhan said. “The majority of chlamydia infections do not have symptoms. If left untreated, it can lead to pelvic inflammatory disease, which leaves these young women at risk for atopic pregnancy, chronic pelvic pain or infertility,” she said.

In addition, the study found that 2.9 percent of young women had trichomoniasis, and 2 percent were infected with genital herpes, Forhan said.

According to Forhan, about 50 percent of the teens reported having sex, and the prevalence of STDs in this group was 40 percent. “Even for young women with only one reported lifetime sexual partner, one in five had an STD,” she noted.

“If you choose to be sexually active, you need to protect yourself and be screened for these infections,” Alderman said. “And all girls between the ages of 11 and 26 should get vaccinated for HPV.”

Among women with an STD, 15 percent had more than one infection, Forhan added.

“These data provide a clearest picture to date of the overall burden of STDs in adolescent women in the United States,” Forhan said. “The study also underscores the importance of addressing racial disparities in STD rates among young women.”

Race itself is not a risk factor for STDs, Forhan said. However, factors such as limited access to health care, poverty, community prevalence of STDs, and misperceptions about individual risk are some of the reasons that STD rates are particularly high among African-Americans, she said.

Comments:

The female population in the United States ages 0-19 is estimated to be 40,328,895. This sample consisted of slightly over 800 girls. Who were they? What is their way of life? Based on this sample, it is recommended to vaccinate all girls. There are less risky ways to foster the health (if that is the goal) of young girls.