The clinical relevance of the epidemiology of ovarian cancer.

This paper reviews some clinically relevant aspects of the epidemiology of ovarian cancer. The items presented and discussed are: (1) incidence and mortality data: they show substantial stability in all Western countries over the last few decades; (2) risk factors: the relationships with child-bearing patterns and other reproductive variables (age at menarche and at menopause; oral contraceptives) appear well established but no risk factor is sufficiently strong to be of practical value in prevention or early diagnosis: (3) long-term survival: in spite of the large number of clinical studies that have claimed 'more effective' treatments, no improvement of long-term survival in the population as a whole has been established. Some discrepancies and drawbacks in published trials are discussed, and a different approach towards clinical studies is suggested.