Ovarian cancer risk and family history

Abstract

Kristensen and Tropé's seminar on epithelial ovarian carcinoma (Jan 11, p 113)1Kristensen GB Tropé C Epithelial ovarian carcinoma.Lancet. 1997; 349: 113-117Summary Full Text Full Text PDF PubMed Scopus (124) Google Scholar covered much useful ground, but perpetuated one critical error which arose from the US National Institutes of Health consensus conference on ovarian cancer.2NIH Consensus conference. Ovarian cancer: screening, treatment, follow-up.JAMA. 1995; 273: 491-497Crossref PubMed Scopus (324) Google Scholar This error could have serious consequences for women at risk who are considering their preventive options. The consensus conference suggested that the risk of ovarian cancer for a woman with two first-degree relatives with this cancer was 7%. In the UK, one in 120 women develop ovarian cancer. From a large and reliable death-certificate-based study, the relative risk of ovarian cancer was 2·3 if one first-degree relative was affected.3Easton DF Ford D Matthews FE Peto J The genetic epidemiology of ovarian cancer.in: Sharp F Mason WP Blackett T Berek J Ovarian cancer. Chapman and Hall, London1995: 3-12Google Scholar Importantly, the UK study has shown that the risk of ovarian cancer is much higher if two first-degree relatives have been diagnosed with ovarian cancer (four observed, 0·15 expected, relative risk 27). Most of these families will have other relatives with early-onset breast cancer, and in many cases the ovarian and breast cancers will segregate with BRCA1 or BRCA2 mutations. In rare families, mutations may be present in mismatch repair genes. In our clinical practice, we would give a risk of about 20% to a woman in this situation. We believe the 7% risk value2NIH Consensus conference. Ovarian cancer: screening, treatment, follow-up.JAMA. 1995; 273: 491-497Crossref PubMed Scopus (324) Google Scholar now widely cited is an error that could be misleading for women with two affected first-degree relatives.