Ovarian cancer

No cancer is desirable, but a glance at the statistics is enough to suggest that a diagnosis of ovarian cancer is particularly unfortunate. Last year, an estimated 314,000 people worldwide developed ovarian cancer. Within the next five years, around half of them will die. By comparison, around 90% of people with breast cancer will survive for at least five years after diagnosis.

Such a poor rate of survival creates a compelling case for substantial investment in ovarian cancer research, but the disease has been somewhat overlooked. Between 2007 and 2014, the US National Cancer Institute provided around 19 times more funding for breast cancer research than it did for the study of ovarian cancer, as judged by the ratio of ‘funding to lethality’. But, with the burden of the disease only expected to rise, it is fortunate that advances in understanding ovarian cancer have begun to yield improvements in care.

The clearest breakthrough of the past few years is the development of PARP inhibitors — a class of drugs whose use is steadily expanding. Similarly, the realization that many cases of ovarian cancer arise in the fallopian tubes is driving trials of preventive surgeries. Efforts to tackle the emergence of tumours that resist the standard platinum-based chemotherapy could also help to improve the prospects of someone with the disease. And momentum is building behind calls to address disparities in ovarian cancer care between Black and white women.

One thing that could make a big difference to the disease’s low survival rate is reliable early diagnosis. Sadly, this is proving difficult. Earlier this year, a 20-year trial of ovarian cancer screening proved the screening was unable to reduce mortality. Now, the hunt is on for new markers of ovarian cancer — leading some researchers to investigate what part vaginal microbes might play. For the moment, the most effective predictive tool remains a person’s genetic make-up; certain mutations can considerably increase a person’s risk of ovarian cancer. However, genetic testing does not always provide people with the clear path forwards that they might have hoped for.

We are pleased to acknowledge the financial support of GlaxoSmithKline in producing this Outlook. As always, Nature retains sole responsibility for all editorial content.