General Considerations
Chemoprevention
Oral contraceptive pill The use of OCPs is associated with a risk reduction in ovarian cancer of almost 50%, with longer duration of use (>3 years) associated with further reductions in risk, and this risk reduction persists after cessation of the OCP. The cardiovascular risks for women in the general population taking the OCP are well known, however both the breast cancer and cardiovascular risk for women at high risk of ovarian cancer taking the OCP is uncertain. The possible risks need to be balanced against the likely benefits of prescribing the OCP to women to reduce their risk of ovarian cancer.
Issues around surveillance
Ovarian cancer surveillance is not recommended for women at high or potentially high risk. Evidence shows that ultrasound or CA125, singly or in combination, is not effective at detecting early ovarian cancer. The most effective risk-reducing strategy for ovarian cancer is bilateral salpingoophorectomy.
Risk-reducing salpingo-oophorectomy
Risk-reducing salpingo-oophorectomy is a surgical procedure which includes the complete removal of both fallopian tubes and ovaries. RRSO provides a substantial reduction in the risk of developing ovarian and fallopian tube cancers in women with a BRCA1/2 gene mutation.