Juniper Publishers | Journal of Gynecology and Women’s Health

Ovarian Carcinoma: The Challenge of Early Diagnosis - Journal of Gynecology and Women’s Health-Juniper Publishers

JUNIPER PUBLISHERS- JOURNAL OF GYNECOLOGY AND WOMEN’S HEALTH

Ovarian Carcinoma: The Challenge of Early Diagnosis

Authored by Liane Deligdisch

Ovarian Cancer (OC) is the most lethal gynecologic tumor, notorious for being diagnosed in late stages. About 14.000 women in the USA and 160.000 women worldwide die every year of OC. In the USA approximately 23.0000 new cases are predicted to be diagnosed in 2016. Morbidity and mortality due to OC have changed very little over the past 5 decades, despite extensive basic research efforts, identification of risk factors, chemotherapy and cytoreductive surgery. This is in contrast with other gynecologic malignancies which underwent spectacular declines of their mortality rates, such as cervical cancer, due to the identification of precursor lesions and of etiopathogenic infections (HPV). OC results in more deaths than all other gynecologic cancers combined in the USA.The reason for this dismal outcome is the fact that the vast majority of cases (about 80%) are diagnosed in advanced stage of disease when the tumor is spread beyond the ovary (ies). This is due to the lack of specific early symptoms a notion recently challenged [1] and of reliable sensitive and specific tumor markers in the serum. Ca 125 is a marker used for follow-up of advanced stage OC treated with chemotherapy but is not effective in early stage OC. Anatomic characteristics of the ovaries such as their hidden location in the pelvis/abdomen and paucity of sensorial nerves (early tumors are painless and clinically mute) preclude an early diagnosis despite the current sophisticate technologies of pelvic visualization. The risk for developing OC is still poorly understood: a small percentage (about 10%) of women with inherent mutated BRCA 1 and2 genes are known to be at risk, while most cases of OC are considered to be sporadic.


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