Clinical Guideline: Screening for Ovarian Cancer: Recommendations and Rationale

doi:10.1059/0003-4819-121-2-199407150-00011

Clinical Guideline: Screening for Ovarian Cancer: Recommendations and Rationale

American College of Physicians.

This guideline was authored by Karen J. Carlson, MD, Steven J. Skates, PhD, and Daniel E. Singer, MD, and was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Ernest L. Mazzaferri, MD, Chair; John R. Feussner, MD; Gerald R. Kerby, MD; Francis J. Klocke, MD; Keith I. Marton, MD; Alvin I. Mushlin, MD; Valerie Anne Palda, MD; and George E. Thibault, MD. Members of the Health and Public Policy Committee were: Gerald E. Thomson, MD, Chair; Charles E. Harrison, Jr., MD, Vice-Chair; Whitney Addington, MD; Robert A. Berenson, MD; Christine K. Cassel, MD; Nancy E. Gary, MD; Sheldon Greenfield, MD; David J. Gullen, MD; L. Julian Haywood, MD; Ana Maria Lopez, MD; Ernest L. Mazzaferri, MD; Mack V. Traynor, Jr., MD; and James R. Webster, Jr., MD. The guideline was approved by the Board of Regents on 21 November 1993. Requests for Reprints: Linda Johnson White, Director, Department of Scientific Policy, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106-1572.

The numbers in square brackets correspond to numbered paragraphs in the review article “Screening for Ovarian Cancer” (see pages 124-132), which support statements made here.—The Editor

Common epithelial tumors account for 90% of ovarian cancers. These tumors derive from the visceral peritoneum of the ovary and from remnants of Mullerian epithelium outside the ovary.

More than 20 000 women are diagnosed with ovarian cancer annually and more than 12 000 die from the disease, making ovarian cancer the most frequent cause of death from gynecologic malignancy.

Risk factors for ovarian cancer include age, a family history of ovarian cancer, and hereditary ovarian cancer syndromes [3.4-3.9]. Pregnancy and use of the oral contraceptive pill are associated with a reduced risk for ovarian cancer [3.10-3.11].