Epithelial ovarian cancer. Risk factors, screening and the role of prophylactic oophorectomy

Hippokratia 2007, 11(2):63-66

A Daniilidis, V Karagiannis
3rd Dpt of Obstetrics and Gynaecology, Hippokration Hospital, Thessaloniki, Greece


Epithelial ovarian cancer is the seventh most frequent can­cer in European women. Many theories have been pos­tu­lated regarding the pathogenesis of ovarian can­cer. Risk factors are not well defined, with the ex­ception of low parity and oral contraceptive use. Approxi­mately 10% of ovarian cancer are hereditary, with BRCA1 and BRCA2 ex­plaining the majority (approxi­mately 90%) of hereditary ovarian can­cer cases. The lifetime risk varies between 15 and 66%, sug­ gesting the existence of modi­fying genetic or en­vi­ron­men­tal factors. Family history can be used to define women who are at increased risk of ovarian cancer. Individuals at high risk are those with a first degree relative (mother, father, sister, brother, daugh­ter or son) affected by can­cer. It must be noted that currently available tests do not attain the afore­men­tioned high level of sensitivity. Evidence suggest that presymptomatic screening by grey scale ul­tra­sound (with or without Doppler), CA125, pelvic examination, or com­bi­nations of these, are not effective in detecting tumors at an early stage. Women identified as being at high risk of ova­rian cancer can be offered pro­phy­lac­tic oophorec­tomy. The decision whether or not to proceed to pro­phy­lac­tic oophorec­tomy is influenced by the fact that most women at in­creased risk of ovarian cancer are also at increased risk of breast cancer and there is evi­dence that oophorec­tomy reduces breast cancer in these cases.

Keywords: prophylactic oophorectomy, CA125, hereditary cancer

Correspoding author: Daniilidis A, 81 Nimfeou, 54224, Thessaloniki, Greece, tel: + 306932211395, e-mail: angedan@hotmail.com