Familial ovarian cancer screening

Familial predisposition accounts for approximately 10% of epithelial ovarian cancer. Identification and management of at-risk families is therefore an important area that bridges gynaecological and clinical genetic practice. The efficacy of screening for ovarian cancer in both high- and low-risk populations is currently of unproven benefit and is associated with some risks related to false-positive results. In contrast to the general population, preventive surgery is a realistic proposition for many women at high-risk. Although prophylactic bilateral salpingo-oophorectomy prevents ovarian and tubal cancer and reduces the risk of breast cancer, this option is unsuitable for women who have yet to complete their families or who are unwilling to undergo surgery. There is therefore a continued demand for screening in the high-risk population. This chapter discusses the limitations of screening, the circumstances under which screening is appropriate and current screening guidelines. Ongoing and future research that should help to provide additional information about this area is also reviewed.