Kerlikowske K, Brown J S, Grady D G
General Internal Medicine Section, Department of Veterans Affairs, San Francisco, California.
Obstet Gynecol. 1992 Oct;80(4):700-7.
To estimate the lifetime probabilities of ovarian cancer in women from families with hereditary ovarian cancer syndromes and those with a family history of ovarian cancer, and to assess the needs for prevention and surveillance in such women.
We searched for studies of familial ovarian cancer published since 1966 and used ovarian cancer incidence data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute.
Pooled estimates of relative risk of ovarian cancer among women with a family history of ovarian cancer were derived using statistical methods based on fixed effects. Modified life-table methods were used to estimate the lifetime probability of ovarian cancer.
The lifetime probability of ovarian cancer increases from about 1.6% in a 35-year-old woman without a family history of ovarian cancer to about 5% if she has one relative and 7% if she has two relatives with ovarian cancer. The lifetime probability may decrease to about 3-4% if she takes oral contraceptives for 5-9 years. Women from families with hereditary ovarian cancer syndromes may have as high as a 50% lifetime risk of ovarian cancer.
The risk of ovarian cancer in women from families with hereditary ovarian cancer syndromes is sufficiently high to warrant prophylactic oophorectomy. Among women with one relative with ovarian cancer, the lifetime probability of ovarian cancer is not high enough to recommend oophorectomy. However, some women may choose oophorectomy depending on their attitudes concerning risk-taking, surgery, and hormone replacement. Oral contraceptives should be considered as preventive therapy to decrease the risk of ovarian cancer in women with a family history of ovarian cancer.
评估患有遗传性卵巢癌综合征家族的女性以及有卵巢癌家族史的女性患卵巢癌的终生概率，并评估此类女性的预防和监测需求。
我们检索了1966年以来发表的家族性卵巢癌研究，并使用了美国国立癌症研究所监测、流行病学和最终结果计划中的卵巢癌发病率数据。
采用基于固定效应的统计方法得出有卵巢癌家族史女性患卵巢癌相对风险的合并估计值。使用改良寿命表法估计卵巢癌的终生概率。
无卵巢癌家族史的35岁女性患卵巢癌的终生概率约为1.6%，有一位亲属患卵巢癌时该概率增至约5%，有两位亲属患卵巢癌时则为7%。若服用5 - 9年口服避孕药，终生概率可能降至约3 - 4%。患有遗传性卵巢癌综合征家族的女性患卵巢癌的终生风险可能高达50%。
患有遗传性卵巢癌综合征家族的女性患卵巢癌风险足够高，足以进行预防性卵巢切除术。对于有一位亲属患卵巢癌的女性，其患卵巢癌的终生概率不足以推荐进行卵巢切除术。然而，一些女性可能会根据她们对风险承担、手术和激素替代的态度选择卵巢切除术。对于有卵巢癌家族史的女性，应考虑将口服避孕药作为降低卵巢癌风险的预防性治疗方法。
