While the presence of one or more risk factors may increase a woman's chance of getting ovarian cancer, it does not necessarily mean she will get the disease. A woman with one or more risk factors should be extra vigilant in watching for early symptoms. Risk factors include:
- Genetic predisposition
- Personal or family history of breast, ovarian or colon cancer
- Increasing age
- Undesired infertility
- All women are at risk
- Symptoms exist - they can be vague, but increase over time
- Early detection increases survival rate
- A Pap test DOES NOT detect ovarian cancer
Current recommendations for management of women at high risk for ovarian cancer are summarized below:
- Women who appear to be at high risk for ovarian or breast cancer should undergo genetic counseling and, if the risk appears to be substantial, may be offered genetic testing for BRCA1 and BRCA2.
- Women who wish to preserve their reproductive capacity can undergo screening by transvaginal ultrasonography every 6 months, although the efficacy of this approach is not clearly established.
- Oral contraceptives should be recommended to young women before they embark on a planned family.
- Women who do not wish to maintain their fertility or who have completed their family may undergo prophylactic bilateral salpingooophorectomy. The risk should be clearly documented, preferably established by BRCA1 and BRCA2 testing, before oophorectomy. These women should be counseled that this operation does not offer absolute protection because peritoneal carcinomas occasionally can occur after bilateral oophorectomy.
- In women who also have a strong family history of breast cancer, annual mammography screening should be performed beginning at age 30 years.
- Women with a documented HNPCC syndrome, also called Lynch syndrome, should undergo periodic screening mammography, colonoscopy, and endometrial biopsy.
Hereditary Cancer Quiz: Take this quiz to assess your cancer risk
1. American Society of Clinical Oncology. Statement of the American Society of Clinical Oncology: genetic testing for cancer susceptibility. Journal of Clinical Oncology, 1996; 14: 1730-1736.
2. NIH Consensus Development Panel on Ovarian Cancer. Ovarian Cancer: Screening, treatment, and follow-up. JAMA, 1995; 273:491-497.