Developing intervention/prevention strategies for individuals at high risk of developing hereditary ovarian cancer.

In 1994, an estimated 24,000 new cases of ovarian cancer will be diagnosed in the United States. Most of these patients will have disease spread beyond the ovary at the time of diagnosis; despite tumor debulking and aggressive platinum-based chemotherapy, their long-term prognosis is poor. In view of the advanced stage of disease at the time of diagnosis and the poor results of conventional therapy, advances in early detection and/or prevention are desperately needed. The recent recognition that a family history of the disease is perhaps the strongest risk factor for the development of ovarian cancer offers a unique opportunity to identify women at high risk for ovarian cancer and to develop effective screening methods and prevention/intervention strategies for these high-risk women. The results of the breakout session "Developing Strategies for Intervention/Prevention Trials for Individuals at Risk of Hereditary Ovarian Cancer" are summarized here. The majority of the discussion in this session focused on three major issues: 1) identification of moderate- and high-risk individuals who would potentially benefit from screening, prevention, and intervention efforts; 2) assessment of the effectiveness of current screening modalities and the usefulness of current intervention/prevention strategies; and 3) recommendations for clinical trial design.