More women at risk of ovarian cancer should get surgery, researchers say

The number of cases of ovarian cancer could be reduced if more at-risk women were offered pre-emptive surgery, experts have said.

Surgery to remove the ovaries and fallopian tubes is the "best method" for preventing ovarian cancer among women deemed to be at high risk of getting the disease, they said.

At present, only those deemed to have a 10% risk, or higher, are eligible for an operation.

But if those aged over 40 who have a 4% chance of getting ovarian cancer in their lifetime were offered the surgery the NHS could save money and there would be a decrease in the number of women diagnosed with the disease, a team of UK researchers said.

It would also help compensate for the current lack of a reliable test to screen for the disease.

Risk factors include having a first-degree relative affected by the disease and carrying genes linked to it, such as BRACA1/2.

The new study, published in the Journal of Medical Genetics, examined the cost effectiveness of the current 10% threshold and looked to see whether lowering it would save any additional money.

The calculations showed that pre-emptive surgery at a lifetime risk level of 4% or greater would be highly cost effective among women aged at least 40, and add up to around 43 extra days of life expectancy if hormone replacement therapy were taken until natural menopause.

"Our results are of major significance for clinical practice and risk management in view of declining genetic testing costs and the improvements in estimating an individual's ovarian cancer risk," the authors wrote.

"With routine clinical testing for certain moderate penetrance genes around the corner and lack of an effective ovarian cancer screening programme, these findings are timely as it provides evidence supporting a surgical prevention strategy for 'lower-risk' individuals.

"Such an approach can contribute to decreasing the number of ovarian cases and disease burden within the population.

"This is a key measure needed for moving towards a predictive, preventive, personalised and participatory medicine."

Across the UK, there were 7,200 cases of ovarian cancer diagnosed in 2013, according to Cancer Research UK figures.

And in 2012, there were more than 4,200 deaths from the disease.

Katherine Taylor, chief executive at the charity Ovarian Cancer Action, said: "We welcome this study as it helps raise the profile of cancer prevention strategies for women at risk of ovarian cancer.

"It also demonstrates that it's vital for women to have informed discussions with their clinicians about their personal risk, options for preventing ovarian cancer - particularly for those who have an inherited predisposition - and the role of HRT after any surgery.

"The key is to know your options and risk so you can choose the path that's right for you."

Annwen Jones, chief executive of the charity Target Ovarian Cancer, said: "These are interesting results and any potential in reducing the number of people dying from ovarian cancer is to be welcomed.

"It is essential that any woman considering her risks has access to appropriate advice and support to understand the risks and benefits of preventative surgery."