A PROPOSAL OF OVARIAN-CANCER PREVENTION PROGRAM IN CROATIA

The aim of this study was to estimate the possibilities of ovarian can cer prophylaxis in the Republic of Croatia, expressed both as the abso lute number of cases per year that could be prevented, and as the shar e of preventable cases in a total number of diagnosed ovarian cancer c ases. The prophylactic measures that are accepted and well-established in the world literature include prophylactic ovariectomies in patient s with family history of ovarian cancer (recommended at 35 years of ag e), in those who underwent hysterectomy (40 years), or non-gynecologic al laparotomy due to any cause (45 years, with patients approval). Ano ther well-recognized prophylactic measure is the use of oral contracep tives over the 4-5 year period, which reduces the risk of ovarian canc er for about 40%. The estimation of the prevention potential was carri ed out retrospectively on the sample of 500 patients treated for ovari an cancer at the Department of Gynecological Oncology of the Universit y Hospital for Gynecology and Obstetrics in Zagreb between 1980 and 19 90. The results of the study revealed a family history of ovarian canc er prior to diagnosis in 15 (3.0%) patients, a hysterectomy prior to d iagnosis in 36 (72%) patients, anal non-gynecological laparotomy prior to diagnosis in additional 33 (6.6%) patients. Among these 84 (16.8%) ovarian cancer cases, a total of 65 (13.0%) could have been avoided t hrough the appliance of prophylactic ovariectomies, respecting recomme nded age limits. Furthermore, if the share of the Croatian female popu lation that regularly uses oral contraceptives reached the level of 12 .5% additional 5% of total ovarian cancer cases would be avoided. Thro ugh the consequent employment of aforementioned prophylactic postulate s, a total of 70 cases of ovarian cancer (18%) could be prevented each year in the Republic of Croatia.