Highlights
- •Up to 17% of ovarian cancers are potentially preventable through population-based genetic testing of known cancer genes.
- •To improve the cure rate there must be an increase in the proportion of women with no residual disease after primary surgery.
- •This may be achieved through a combination of aggressive surgery and wider application of the CA125 screening test.
Abstract
Over the last 40 years, the age-adjusted ovarian cancer mortality rate in the USA declined by 23%.
The decline in mortality paralleled a decline in incidence, which was largely due
to changes in reproductive risk factors. There was no reduction in ovarian cancer
case-fatality at 12 years, indicating that improvements in early detection or in treatment did not contribute
to the decline in mortality. Here, we discuss potential strategies to further reduce
ovarian cancer mortality through prevention, early detection and treatment. The first
approach is to increase genetic testing, in order to identify women who are at a high
risk of developing ovarian cancer and offer them preventive bilateral salpingo-oophorectomy.
At present, up to 17% of ovarian cancers are potentially preventable through population-based
genetic testing of known ovarian cancer susceptibility genes. The second approach
is to increase the proportion of ovarian cancer patients who achieve a status of no
residual disease through primary debulking surgery and subsequently receive adjuvant
intraperitoneal chemotherapy. We believe that through a combination of screening to
better identify low-volume advanced stage ovarian cancer, aggressive surgery to leave
no residual disease and adjuvant intraperitoneal chemotherapy, the cure rate of ovarian
cancer might be improved significantly.
Keywords
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Article info
Publication history
Published online: June 15, 2015
Accepted:
June 12,
2015
Received in revised form:
June 9,
2015
Received:
April 10,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
