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Prevention of Ovarian Cancer

Intraepithelial Neoplasia

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Arizona Cancer Center, University of Arizona, Tucson, Arizona 85724 [M. A. B.]; Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland 20892 [K. J.]; Departments of Gynecologic Oncology [M. A. B., M. F., D. G.] and Translational Research [R. B.], The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030; and Department of Obstetrics, Gynecology and Reproductive Science, University of Texas Medical School, Houston, Texas 77030 [M. F.]

To reduce the incidence and mortality associated with invasive cancers, the Intraepithelial Neoplasia (IEN) Task Force recommends that carcinogenesis be viewed as a disease that requires treatment. This publication outlines the current knowledge of IEN of the ovary and reviews chemoprevention possibilities for ovarian cancer. Ovarian cancer has the highest mortality of all of the gynecological cancers and is the fourth leading cause of death from cancer in women. The IEN Task Force has defined precancer as a noninvasive lesion that has genetic abnormalities, loss of cellular control functions, and some phenotypic characteristics of invasive cancer with a substantial likelihood of developing invasive cancer. The IEN Task Force recommends targeting moderate to severe dysplasia for new IEN treatment agents in clinical trials. Ovarian cancer does not have a clear preinvasive lesion yet merits considerable study for new prevention strategies because of the high mortality associated with ovarian cancer. There is a great unmet clinical need for treatments that can prevent ovarian cancer by providing nonsurgical options that treat the entire epithelial layer. New prevention strategies hold significant promise to reduce the mortality from ovarian cancer.

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