Ovarian cancer and its detection

This chapter discusses the strategies involving early detection of early-stage disease that may significantly impact women's health care. Risk Assessment comprises a test of modifiable risk factors and heritable factors. A family history of ovarian cancer is the strongest risk factor for the development of epithelial ovarian Cancer (EOC). The relative risk of EOC for a woman with one first-degree relative with ovarian cancer is 3.1; with two or more affected relatives. Hereditary EOCs are predominantly serous carcinomas, high grade, late stage, nonmucinous or borderline, but have longer overall survival and recurrence-free intervals after chemotherapy. A few basic concepts are reviewed to better understand the role of a screening test. Sensitivity is the percentage of patients with the disease who are correctly identified by a positive test result. Specificity is the percentage of patients without the disease who are correctly identified by a negative test result. Thus, a test with 98% specificity would result in 50 procedures for every case of EOC detected on screening in postmenopausal women. Better insights into the biologic basis of cancer and the tumor-host microenvironment have facilitated development of novel screening modalities for EOC.