9 - Ovarian cancer standards of care

Summary

Introduction

Ovarian cancer is the fourth most common cause of cancer deaths in women and the leading cause of gynaecological cancer death in Europe, with a lifetime prevalence in the developed world of 1–2%. The incidence increases with age, peaking in the eighth decade, with a median age at diagnosis of 63 years. It is often described as a silent killer but early symptoms of abdominal bloating, urinary frequency, a sensation of fullness and pelvic or abdominal pain are frequently reported. As these symptoms are non-specific, they are often dismissed by both women and healthcare professionals. When ovarian cancer is detected, it is usually at an advanced stage with a poor prognosis. In the UK, ovarian cancer kills 4400 women each year, more women than all of the other gynaecological malignancies combined.

Survival for ovarian cancer patients in the UK has increased over time but the average survival still lags behind the Nordic countries and the USA. Childbearing, breastfeeding and use of the oral contraceptive pill all protect against the development of ovarian cancer. This is thought to be due to a reduced number of ovulatory cycles minimising the damage and repair cycle of the ovarian epithelium. It is likely, therefore, that the increased incidence of ovarian cancer over the past few decades is partly due to reduced parity. Patients with ovarian cancer are best cared for by multidisciplinary teams.