Prevention of Ovarian Cancer

Abstract

Prevention of ovarian cancer is critical in reducing the mortality and morbidity for patients with ovarian cancer. Growing evidence suggests that primary and secondary prevention of ovarian cancer in women with average risk do not confer mortality benefits. Primary surgical prevention through risk-reducing salpingo-oophorectomy is the most effective way of preventing ovarian cancer. This chapter focuses on the assessment of genetic and nongenetic risk factors for ovarian cancer that eventually guide surgical prevention and chemoprophylaxis in women with high-risk disease. It is emphasized that adequate family history and appropriate genetic counseling referral by the physicians is the key to recommend surgical or medical prevention for ovarian cancer. Recent insights into the site of precursor lesion and natural history of the disease have suggested that significant proportion of aggressive ovarian cancer originates as a premalignant lesion in the fallopian tube, making bilateral salpingectomy as a potential preventative option for a group of women requesting short-term ovarian preservation.