NATURAL HISTORY OF OVARIAN CANCER AND TARGETED APPROACHES TO SCREENING AND PREVENTION IN HIGH-RISK POPULATIONS
PublisherThe University of Arizona.
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AbstractOvarian cancer is the most lethal gynecologic malignancy and is associated with a five-year survival rate of approximately 45%. High-grade serous carcinoma is commonly diagnosed at an advanced stage due to late manifestation of symptoms and limited efficacy of current detection strategies. A thorough understanding of the mechanisms of tumorigenesis and associated risk factors is required for targeted prevention and may be the best way to reduce mortality. Among epithelial ovarian cancers, high-grade serous carcinoma poses the greatest challenge for screening; at this time, no effective screening method exists. Women of general risk are not recommended to undergo screening, while women with inherited risk may consider a cancer antigen (CA)-125 test and transvaginal ultrasound, as well as genetic counseling. This literary review critically analyzes the current application of prophylactic strategies for women who are genetically predisposed to ovarian cancer. For these women, surgical intervention with bilateral risk-reducing salpingo-oophorectomy is currently the most effective preventive measure. However, alternative surgical and medical options, albeit with limited efficacy, may be considered for women desiring fertility preservation or wishing to delay surgically induced menopause.