abstract
Highlights
- •Up
to 17% of ovarian cancers are potentially preventable through
population-based genetic testing of known ovarian cancer susceptibility
genes
- •Primary debulking
surgery leaving no residual disease followed by intraperitoneal
chemotherapy appears to hold the greatest potential for cure
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.
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