Epidemiological factors and prophylaxis of ovarian tumors.

PIP: 2 theories explaining the common epithelial ovarian carcinoma are: 1) regular ovulations without interruptions can make the epithelium susceptible to a malignancy, and 2) when a carcinogen is introduced into the vagina, it reaches the surface ovarian epithelium through the uterus and the open tubes within 25 minutes. Premalignancy consists of 2 basic concepts, the transformation and the following spread. Important risk factors are: 1) dietary habits, especially a high fat intake; 2) presence of selected families with a familial development of epithelial ovarian tumors; 3) the lesions which are at the limits of malignancy; and 4) the cellular dysplasia of the ovarian epithelium. There is also a good relationship between socioeconomic situations, nutritional state, and increased ovarian carcinoma occurrence. Occurrence is also higher in white women which can be related to a connection between habits of living involving the socioeconomic state and the rate of ovarian neoplasms. The most frequent factors among common ovarian epithelial carcinomas are thought to be early menopause (under age 45), delayed menarche (over age 14), and a lower number of pregnancies. Pregnancy, even if not carried to its full-term, must be considered a factor decreasing the risk of a malignant ovarian neoplasm. Among the most important environmental factors studied are estrogens and viral agents. Prophylactic factors are: 1) histological and surgical diagnosis of any solid of cystic adnexal tumefaction, 2) investigation and control of any cystic mass, 3) detection and control of all cystic adnexal masses increasing their size during the observation of the group of patients in fertile age, 4) detection and control of any unilateral cystic ovarian neoplasm with a diameter lower than 10 cm, 5) control of all palpable ovaries in postmenopausal women, 6) control of all patients with adenomatoid hyperplasia of the endometrium, 7) removal of roughly pathological ovaries in women under age 35 during pelvic surgery for malignant or benign disease, 8) possible hysterectomy and bilateral ovariosalpingotomy in women having 2 or more close relations affected by ovarian neoplasm, and 9) ovaries ablation in women 35 or older who undergo pelvic surgery for a benign or malignant disease.^ieng

Clinical evaluation of an oral contraceptive containing Ethinyl-Oestradiol (30 mcg) and Gestoden (75 mcg).

At the Family Planning Center AIECS in Bari, 383 women have been treated for 6 cycles with an estroprogestinic combination containing Ethinyl-Oestradiol (30 mcg) and Gestoden (75 mcg). We evaluated the following parameters: contraceptive efficacy, cycle control, side effects and acceptability. At the end of the treatment, 346 women (90.4%) decided to continue the treatment while only 22 expressed a negative opinion. The clinical experience has been positively considered by the physician, considering the high contraceptive efficacy, even if 12% of women forgot to take the pill (Pearl Index 0.00) side effects profile and cycle control.