1. Gynecological Malignancies

2. Gynecologic malignancies account for 15% of all cancers in women. Gynecologic malignancies account for 15% of all cancers in women. Primary tumor sites: Ovary Primary tumor sites: Ovary Uterus Uterus Cervix Cervix Vulva Vulva Vagina Vagina Fallopian tube Fallopian tube

3. Annual Female Cancer Cases and Death in U.S.A, 1997 Site New Cases Deaths Breast 181,600 43,900 Gyn. Malig. 81,800 26,500 Ovary 26,800 14,200 Endometrium 34,900 6,000 Cervix 14,500 4,000

4. Early Detection of Gynecological Cancer Pap smear for ca. of cervix – 20% false negative. Cost – effective screening in most countries. Pap smear for ca. of cervix – 20% false negative. Cost – effective screening in most countries. Ovarian cancer – Pelvic exam., T.V color- doppler U.S, CA-125 – Non cost-effective. Ovarian cancer – Pelvic exam., T.V color- doppler U.S, CA-125 – Non cost-effective. Family history: Positive compared to negative-1 st degree relatives – R.R-3.6 Family history: Positive compared to negative-1 st degree relatives – R.R-3.6 2 nd degree relatives – R.R-2.9 2 nd degree relatives – R.R-2.9

5. Early Detection (cont.) Clinical genetic service – Breast/ovarian cancer syndrome – BRCA1, BRCA2. Lifetime risk of developing ovarian cancer – 10 – 70%. - No effective screening for endometrial cancer. - WHO recommendation for all women – annual pelvic examination. annual pelvic examination.