Society of Gynecologic Oncology Recommendations for the Prevention of Ovarian Cancer

Walker, Joan L.; Powell, C. Bethan; Chen, Lee May; Carter, Jeanne; Jump, Victoria L. Bae; Parker, Lynn P.; Borowsky, Mark E.; Gibb, Randall K.

doi:10.1097/01.ogx.0000469976.39471.e2

Cited by 59 publications

(93 citation statements)

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“…For women of average risk, the risk reduction can be up to 40-50 %, lasting 15 years after discontinuation of use [45,60,114]. This risk reduction by the use of OC is also observed in BRCA1/2 mutation carriers [11,12,40,46,56,78,79,114]. In a meta-analysis, the use of OC was associated with a significant reduced risk of ovarian cancer for BRCA1/2 carriers and a 36 % risk reduction for each additional 10 years of OC use [46].…”

Section: Oral Contraceptionmentioning

confidence: 99%

“…Gierisch et al [37,114,117] recently completed a systematic review of data on the cancer risk of OC use in the general population and concluded that there is a small increased risk of breast cancer (odds ratio [OR] 1.08, 95 % confidence interval [CI] 1.00-1.17). Dose-response analysis showed in one study that every 10-year increment of OC use was associated with a significant 14 % (95 % CI 1.05-1.23) rise in breast cancer risk [117].…”

Section: Oral Contraceptionmentioning

confidence: 99%

“…Four or more years of use, especially before first full-term pregnancy, were associated with an increased risk of breast cancer for both BRCA1 and BRCA2 mutation carriers [9,43] However, OCs can also substantially decrease the risk of ovarian cancer after a short latency period and short duration of use [13,44,45,70]. For women of average risk, the risk reduction can be up to 40-50 %, lasting 15 years after discontinuation of use [45,60,114]. This risk reduction by the use of OC is also observed in BRCA1/2 mutation carriers [11,12,40,46,56,78,79,114].…”

Section: Oral Contraceptionmentioning

confidence: 99%

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“…Die Society of Gynecologic Oncology der USA diskutiert in einer gerade veröffentlichten Stellungnahme als erste Strategie zur Prävention von Typ 1 (lowgrade) und Typ 2 (high-grade) Ovarialkarzinomen die Einnahme von oralen Kontrazeptiva [33]. Ein vom US Department of Health and Human Services in Auftrag gegebener Report (Evidence Report/Technology Assessment No.…”

Section: Ovarialkarzinomunclassified

“…Ist man Anhänger der aktuellen Theorie, dass vor allem die high-grade serösen Ovarialkarzinome in der Tube entstehen, wird ihre Exfoliation auf das Ovar und in die Bauchhöhle durch OC reduziert, indem die Menge des retrograd durch die Tuben menstruierten Materials vermindert wird. Auch das Anwachsen der mutierten Tubenzellen im Ovar wird möglicherweise reduziert, wenn hier unter OC-Einnahme keine rupturierten Follikel vorliegen[33].…”

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In this issue of Cancer, members of the Society of Gynecologic Oncology (SGO) review the etiology of ovarian cancer and present the SGO's recommendations for the prevention of the disease. 1 They call for a concerted effort to identify women at high risk who are most likely to benefit from cancer chemotherapy or surgical prevention.Ovarian cancer is the fifth leading cause of cancer death in women and is the most common cause of death from gynecologic cancer in the Western world. The median age at diagnosis is 63 years, and the lifetime risk of diagnosis for the average American woman is 1.3%. 2 Efforts to find an effective screening test have been unsuccessful, partly because of the nature and biologic behavior of the disease and the inability to find a screening test with sufficient sensitivity and specificity. 3 The failure of screening has added an incentive to study the prevention of the disease.Advances in molecular biology over the past decade have given us new insights into the carcinogenic process and the biology of the disease. The original cell pathologists of the 19th century defined most cancers, including most ovarian cancer pathologies. 4 They were the first to perform microscopic examinations of tumors and created the definitions of cancer that we use to this day. The combination of histopathology with modern molecular biology is moving us from a mid-19th century definition of cancer to a 21st century definition. Indeed, as the SGO article notes, the disease that has been termed ovarian cancer is now understood to originate in the fallopian tubes frequently and occasionally begins in the peritoneal wall. More than half of the most aggressive forms of this pathology likely originate in the fallopian tubes, and effective surgical prevention of the disease will involve salpingectomy. Bilateral oophorectomy without bilateral salpingectomy is rarely indicated.The SGO review and recommendations come at a time when there is tremendous interest in the creation of guidelines. This is a direct result of the movement toward evidence-based medicine and the recent controversies surrounding (and the lack of acceptance of guidelines for) breast and prostate cancer screening. The US Institute of Medicine (IOM) recently published studies on how clinical practice guidelines should be created and how systematic evidence reviews should be conducted. 5,6 The IOM statements are still being digested by the medical community. 7 Some of the IOM principles are useful in interpreting and processing the SGO recommendations. The IOM suggests that recommendations be based on a structured literature review. In that review, the quality of each study should be graded. This should ultimately allow for a rating of the confidence that one has in the recommendation derived from the study or studies. Some have used the phrases "based on solid evidence," "based on fair evidence," and "recommendation cannot be made because evidence is inadequate."The type of study is important in determining the strength of evidence. 8 Study designs ra...

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Society of Gynecologic Oncology Recommendations for the Prevention of Ovarian Cancer

Cited by 59 publications

References 0 publications

Endokrine Interventionen bei Frauen mit BRCA-1/2-Mutation

Endokrine Interventionen bei Frauen mit BRCA-1/2-Mutation

Hormonelle Kontrazeption und Krebs

Ovarian cancer prevention: Time for primetime?

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