Obstet Gynecol. 2017 Sep;130(3):e146-e149. doi: 10.1097/AOG.0000000000002299.
Ovarian cancer is the second most common type of female reproductive cancer, and more women die from ovarian cancer than from cervical cancer and uterine cancer combined. Currently, there is no strategy for early detection of ovarian cancer that reduces ovarian cancer mortality. Taking a detailed personal and family history for breast, gynecologic, and colon cancer facilitates categorizing women based on their risk (average risk or high risk) of developing epithelial ovarian cancer. Women with a strong family history of ovarian, breast, or colon cancer may have hereditary breast and ovarian cancer syndrome (BRCA mutation) or hereditary nonpolyposis colorectal cancer (Lynch syndrome), and these women are at increased risk of developing ovarian cancer. Women with these conditions should be referred for formal genetic counseling to better assess their cancer risk, including their risk of ovarian cancer. If appropriate, these women may be offered additional testing for early detection of ovarian cancer. The use of transvaginal ultrasonography and tumor markers (such as cancer antigen 125), alone or in combination, for the early detection of ovarian cancer in average-risk women have not been proved to reduce mortality, and harms exist from invasive diagnostic testing (eg, surgery) resulting from false-positive test results. The patient and her obstetrician-gynecologist should maintain an appropriate level of suspicion when potentially relevant signs and symptoms of ovarian cancer are present.
卵巢癌是女性生殖系统第二大常见癌症，死于卵巢癌的女性多于死于宫颈癌和子宫内膜癌的女性总和。目前，还没有降低卵巢癌死亡率的卵巢癌早期检测策略。详细了解乳腺癌、妇科癌症和结肠癌的个人和家族史，有助于根据女性患上皮性卵巢癌的风险（平均风险或高风险）对其进行分类。有强烈卵巢癌、乳腺癌或结肠癌家族史的女性可能患有遗传性乳腺癌和卵巢癌综合征（BRCA 突变）或遗传性非息肉病性结直肠癌（林奇综合征），这些女性患卵巢癌的风险增加。这些情况下的女性应转介进行正式的遗传咨询，以更好地评估其癌症风险，包括卵巢癌风险。如果合适，这些女性可能会接受额外的卵巢癌早期检测测试。单独或联合使用经阴道超声和肿瘤标志物（如癌抗原 125）来检测平均风险女性的卵巢癌，并未证明能降低死亡率，而且假阳性检测结果会导致侵入性诊断测试（如手术）带来危害。当存在与卵巢癌相关的潜在症状和体征时，患者及其妇产科医生应保持适当的警惕性。
