[Early detection of ovarian cancer in FB&H--role of family medicine].

PURPOSE Detection of ovarian malignancy in early stage is one of the main problems of modern medicine. In FB&H problem is even larger due to fact that official demographic data are insufficient while National Cancer Registry and National strategy for early detection of ovarian malignancy are not established yet. Overlook of ovarian malignancy in Federation B&H considers comprehensive and precise analysis of populations' characteristics with highlights of risk factors such as: age, parity, hereditary factors, menstrual cycle characteristics, environmental factors. WORK METHOD Retrospective multi-centric study. Disease histories of 272 patients with ovarian cancer within the Federation B&H were analyzed. Usual statistic methods were performed (T- test, chi2 -Test, Fisher exact test) using statistical programme Arcus Quick Stat. WORK RESULTS 1) Disease was diagnosed most often in stage III and IV (60%); 2) Epithelial cancer was diagnosed in 88.6% cases; 3) most frequently in age of 55 to 70; 4) Out of 272 patients null-parity was seen in 16.9% while 19.8% had just one pregnancy; 5) Approximately 1.8% patients had close relatives with cancer of breast, ovary or colon; 6) Menstrual cycle duration shorter than 21day was found in 26,5% cases. DISCUSSION Ovarian cancer is severe disease which is detected mostly in advanced stages and has poor prognosis. Most often disease is detected in perimenopause. Epithelial carcinoma is most often histological type. There are some proven risk factors: age, parity, genetic predisposition. Seeking for those that belong to risk group should be main task in National strategy. Family doctors who are supposed to cover whole population with their activity should be involved in process of identification of risk groups bearing in mind their role in Health System Reform. CONCLUSION Ovarian cancer known as "Silent Killer" due to lack of symptoms and insufficiency of diagnostics methods for early detection. There are some particular problems existing in B&H caused by the lack of National strategy for ovarian cancer early detection. We recommend to medical health officials several activities that should be performed to improve prognosis for patient with such deadly disease: 1. To establish of Cancer registry; 2. To form available official and precise demographic database; 3. To involve family doctors in process of risk group identification; 4. To identify medical centres for early diagnostic, treatment and follow up; 5. To establish algorithms for: diagnostic, treatment and follow up.