SCREENING AND EARLY DETECTION OF EPITHELI AL OVARIAN-CANCER

Epithelial ovarian cancer results in more death each year than maligna ncies of the cervix and the uterus combined. Because the patient's cha nce for survival is much better when the disease is discovered while i t is still confined to the ovary, physicians should be alert to the po ssibility of ovarian cancer in their postmenopausal patients, especial ly those with a palpable ovary, vague abdominal complaints or a family history of this disease. This article presents a brief review of pers onal and environmental characteristics associated with altered risk of ovarian cancer. Possibilities for iii prevention through identifying women at high risk who are possible candidates for screening and early detection will be discussed. Ovarian cancer screening, however, shoul d not be offered to the general population until randomized clinical t rials have been performed determining the efficacy of these modalities and their impact upon ovarian cancer mortality. The methods for preop erative diagnosis and evaluation of women with suspected ovarian neopl asm have evolved significantly. While many surgeons are currently usin g the less invasive laparoscopic approach, the standard of care contin ues to be laparotomy with either an ovarian cystectomy or oophorectomy .