Hereditary Ovarian Cancer: Towards a Cost-Effective Prevention Strategy

Aruni Ghose, Anita Bolina, Ishika Mahajan, Syed Ahmer Raza, Miranda Clarke, Abhinanda Pal, Elisabet Sanchez, Kathrine Sofia Rallis and Stergios Boussios ()
Additional contact information
Aruni Ghose: Department of Medical Oncology, Barts Cancer Centre, St. Bartholomew’s Hospital, Barts Health NHS Trust, London E1 1BB, 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
Stergios Boussios: Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham ME7 5NY, UK

IJERPH, 2022, vol. 19, issue 19, 1-18

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?

Keywords: ovarian cancer; genetic testing; BRCA; risk-reducing surgery; guidelines; cost effectiveness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/19/12057/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/19/12057/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:19:p:12057-:d:923370

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().