There is no place for ovarian cancer screening in hereditary breast–ovarian cancer syndromes

Ovarian cancer is regarded as a lethal disease. Women carrying a BRCA1 or BRCA2 mutation face a higher risk of developing tubo-ovarian cancers, with rates ranging from 40% to 60% and 17% to 35%, respectively. The overall 5-year survival rate for ovarian cancer remains <50%. Screening and prevention are particularly crucial for this high-risk population. According to the European Society for Medical Oncology (ESMO) guideline, risk-reducing bilateral salpingo-oophorectomy (rrBSO) is strongly recommended for BRCA mutation carriers between the ages of 35 and 40 years, with a Level A rating indicating a substantial benefit. 1 Sessa C. Balmaña J. Bober S.L. et al. Risk reduction and screening of cancer in hereditary breast-ovarian cancer syndromes: ESMO Clinical Practice Guideline. Ann Oncol. 2023; 34: 33-47 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar Reply to the Letter to the Editor ‘There is no place for ovarian cancer screening in hereditary breast–ovarian cancer syndromes (in regard to “ESMO Clinical Practice Guideline on risk reduction and screening of cancer in hereditary breast-ovarian cancer syndromes”)’ by W. TjalmaAnnals of OncologyVol. 35Issue 1PreviewWe appreciate the comments of Prof. Tjalma1 regarding the European Society for Medical Oncology (ESMO) Clinical Practice Guideline (CPG) on risk reduction and screening of cancer in hereditary breast-ovarian cancer syndromes2 on the potential harm of screening women for ovarian cancer who harbour a germline pathogenic variant (PV) in BRCA1/2 and the accompanying suggestion to change the strength of recommendation for transvaginal ultrasound (TVUS) from level of evidence C (small benefit, optional) to D (no benefit or harm outweighs benefit). Full-Text PDF