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Hereditary Ovarian Cancer: Towards a Cost-Effective Prevention Strategy

Author

Listed:
  • Aruni Ghose

    (Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London E1 1BB, UK
    Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London SG1 4AB, UK
    Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK)

  • Anita Bolina

    (Department of Medical Oncology, Clatterbridge Cancer Centre, Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool CH63 4JY, UK)

  • Ishika Mahajan

    (Department of Medical Oncology, Apollo Cancer Centre, Chennai 600001, India)

  • Syed Ahmer Raza

    (Department of Internal Medicine, St. Thomas’ Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London SE1 7EH, UK)

  • Miranda Clarke

    (Department of Internal Medicine, Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK)

  • Abhinanda Pal

    (Department of Internal Medicine, IQ City Medical College and Narayana Hospital, Durgapur 713206, India)

  • Elisabet Sanchez

    (Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK)

  • Kathrine Sofia Rallis

    (Cancer Research Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
    Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London E1 4NS, UK)

  • Stergios Boussios

    (Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK
    Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College London, London WC2R 2LS, UK
    AELIA Organization, 9th Km Thessaloniki—Thermi, 57001 Thessaloniki, Greece)

Abstract

Ovarian cancer (OC) is the most lethal gynaecological malignancy. The search for a widely affordable and accessible screening strategy to reduce mortality from OC is still ongoing. This coupled with the late-stage presentation and poor prognosis harbours significant health-economic implications. OC is also the most heritable of all cancers, with an estimated 25% of cases having a hereditary predisposition. Advancements in technology have detected multiple mutations, with the majority affecting the BRCA1 and/or BRCA2 genes. Women with BRCA mutations are at a significantly increased lifetime risk of developing OC, often presenting with a high-grade serous pathology, which is associated with higher mortality due to its aggressive characteristic. Therefore, a targeted, cost-effective approach to prevention is paramount to improve clinical outcomes and mortality. Current guidelines offer multiple preventive strategies for individuals with hereditary OC (HOC), including genetic counselling to identify the high-risk women and risk-reducing interventions (RRI), such as surgical management or chemoprophylaxis through contraceptive medications. Evidence for sporadic OC is abundant as compared to the existing dearth in the hereditary subgroup. Hence, our review article narrates an overview of HOC and explores the RRI developed over the years. It attempts to compare the cost effectiveness of these strategies with women of the general population in order to answer the crucial question: what is the most prudent clinically and economically effective strategy for prevention amongst high-risk women?

Suggested Citation

  • Aruni Ghose & Anita Bolina & Ishika Mahajan & Syed Ahmer Raza & Miranda Clarke & Abhinanda Pal & Elisabet Sanchez & Kathrine Sofia Rallis & Stergios Boussios, 2022. "Hereditary Ovarian Cancer: Towards a Cost-Effective Prevention Strategy," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12057-:d:923370
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    References listed on IDEAS

    as
    1. Alison Cheung & Sidrah Shah & Jack Parker & Pavandeep Soor & Anu Limbu & Matin Sheriff & Stergios Boussios, 2022. "Non-Epithelial Ovarian Cancers: How Much Do We Really Know?," IJERPH, MDPI, vol. 19(3), pages 1-18, January.
    2. Dirk Müller & Marion Danner & Kerstin Rhiem & Björn Stollenwerk & Christoph Engel & Linda Rasche & Lisa Borsi & Rita Schmutzler & Stephanie Stock, 2018. "Cost-effectiveness of different strategies to prevent breast and ovarian cancer in German women with a BRCA 1 or 2 mutation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 341-353, April.
    3. Dirk Müller & Marion Danner & Rita Schmutzler & Christoph Engel & Kirsten Wassermann & Björn Stollenwerk & Stephanie Stock & Kerstin Rhiem, 2019. "Economic modeling of risk-adapted screen-and-treat strategies in women at high risk for breast or ovarian cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 739-750, July.
    4. Antonios Revythis & Anu Limbu & Christos Mikropoulos & Aruni Ghose & Elisabet Sanchez & Matin Sheriff & Stergios Boussios, 2022. "Recent Insights into PARP and Immuno-Checkpoint Inhibitors in Epithelial Ovarian Cancer," IJERPH, MDPI, vol. 19(14), pages 1-19, July.
    5. Sidrah Shah & Alison Cheung & Mikolaj Kutka & Matin Sheriff & Stergios Boussios, 2022. "Epithelial Ovarian Cancer: Providing Evidence of Predisposition Genes," IJERPH, MDPI, vol. 19(13), pages 1-14, July.
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    Cited by:

    1. Iqra Saani & Nitish Raj & Raja Sood & Shahbaz Ansari & Haider Abbas Mandviwala & Elisabet Sanchez & Stergios Boussios, 2023. "Clinical Challenges in the Management of Malignant Ovarian Germ Cell Tumours," IJERPH, MDPI, vol. 20(12), pages 1-16, June.

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