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Chemoprevention for Ovarian Cancer

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Hereditary Breast and Ovarian Cancer

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Abstract

Objectives: This chapter describes the effects and precautions of chemoprevention of ovarian cancer.

Methods: We have collected literature searches reported in English from PubMed and Embase databases between 1990 and 2002.

Results: One of the important risk factors for ovarian cancer is a family history of ovarian and breast cancer. There is no clear evidence that screening tests with transvaginal ultrasonography or serum CA125 alone or in combination can reduce ovarian cancer incidence and mortality. Prophylactic risk-reduction salpingo-oophorectomy is an effective risk management option for ovarian cancer in high-risk populations. Chemoprevention is another option. We investigated the chemopreventive strategies by dividing the subjects into the general population and BRCA1/BRCA2 gene mutation carriers. OC significantly reduces the risk of ovarian cancer in the general population because there is an inverse relationship between the duration of OC use and risk reduction of ovarian cancer, with long-lasting protective effects even after OC is discontinued. In BRCA mutation carriers, several studies, including systematic review, meta-analysis of case-control studies, and case-control studies and review articles, have shown that OC reduces the risk of ovarian cancer, and that the longer OC is used, the lower the risk of ovarian cancer. Relative risk is expected to decrease by over 20% with every 5 years of use. OC significantly reduces ovarian cancer risk in both the general population and BRCA mutation carriers. On the other hand, OC has a modest but significant increased risk of breast cancer in certain BRCA mutation carriers when taking OC from under the age of 20 (or 30) or when using long-term OC before delivery. Use of natural progesterone or dydrogesterone is preferred to avoid increased breast cancer risk. The impact of OC on breast cancer risk is still controversial, so it is essential to consider some details: patient age, duration of use, and progesterone components.

Conclusion: In conclusion, OC shows a clear chemopreventive effect on ovarian cancer, but slightly increases the risk of breast cancer.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan

    Hiroshi Kobayashi

  2. Department of Gynecology, Ms.Clinic MayOne, Kashihara, Japan

    Hiroshi Kobayashi

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  1. Hiroshi Kobayashi
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Correspondence to Hiroshi Kobayashi .

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Editors and Affiliations

  1. Department of Breast Surgical Oncology, Showa University, School of Medicine, Tokyo, Japan

    Seigo Nakamura

  2. Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan

    Daisuke Aoki

  3. Department of Molecular Genetics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan

    Yoshio Miki

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Author Contributions: Hiroshi Kobayashi performed the literature search, collected data using the Web database, and contributed to the interpretation of included research studies.

Funding: No fund.

Ethical Approval: This article does not contain any studies with human participants or animals.

Conflict of Interest: Hiroshi Kobayashi declares that he has no conflict of interest.

Informed Consent (Optional): For this type of study, formal consent is not required.

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Kobayashi, H. (2021). Chemoprevention for Ovarian Cancer. In: Nakamura, S., Aoki, D., Miki, Y. (eds) Hereditary Breast and Ovarian Cancer . Springer, Singapore. https://doi.org/10.1007/978-981-16-4521-1_10

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  • DOI: https://doi.org/10.1007/978-981-16-4521-1_10

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-4520-4

  • Online ISBN: 978-981-16-4521-1

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