New Insights Into the Pathogenesis of Ovarian Carcinoma

Angela Chan, Chan A, C. Blake Gilks, Gilks B, Blake Gilks, Janice Kwon, Janice S. Kwon, Kwon J, Anna V. Tinker, Tinker AV
Obstetrics and gynecology · 2012 · vol. 120(4) , pp. 935–940 · doi:10.1097/aog.0b013e318269b8b1 · PMID:22996112 · W2125679005
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

Ovarian carcinomas are distinct diseases with different origins, requiring subtype-specific screening strategies beyond current methods that focus on serous subtypes and macroscopic abnormalities.

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This review article examines recent discoveries regarding the pathogenesis of ovarian carcinoma, arguing that histologically defined subtypes are distinct diseases with different precursor lesions and biomarker profiles. The authors note that most serous carcinomas likely originate from the fallopian tube, while clear cell and endometrioid carcinomas are associated with endometriosis and may arise from ectopic endometrium. They highlight that previous large-scale screening trials failed to reduce mortality because they focused on macroscopic abnormalities rather than these specific subtypes and their unique origins. Relevance to endometriosis: the paper explicitly links endometriosis to the pathogenesis of clear cell and endometrioid ovarian carcinomas, stating these cancers likely originate from ectopic endometrium.

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Abstract

Recent discoveries about the pathogenesis of ovarian cancer have suggested that it can no longer be thought of as a single entity, but that the histologically defined ovarian cancer subtypes are different diseases, with different precursor lesions and distinct biomarker expression profiles. Most serous carcinomas probably arise from the fallopian tube. Clear cell and endometrioid carcinomas are associated with endometriosis and likely originate from ectopic endometrium. The focus of large ovarian cancer screening trials has been detection of macroscopic ovarian abnormalities by ultrasonography and detection of serum biomarkers associated with the most common (serous) subtype of ovarian cancer. The only completed and phase three randomized controlled trial failed to achieve the objective of reducing ovarian cancer mortality and was not able to demonstrate a stage migration effect of the screening. Future screening strategies have to incorporate our growing understanding of each subtype of pelvic (ovarian or fallopian tube) cancer, its organ of origin, and disease-specific biomarkers. We review how our current understanding of pathogenesis should prompt a reexamination of data from ovarian cancer screening studies and discuss potential designs for future screening strategies.
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New Insights Into the Pathogenesis of Ovarian Carcinoma Time to Rethink Ovarian Cancer Screening - Angela Chan - Blake Gilks - Janice Kwon - Anna V. Tinker Recent discoveries about the pathogenesis of ovarian cancer have suggested that it can no longer be thought of as a single entity, but that the histologically defined ovarian cancer subtypes are different diseases, with different precursor lesions and distinct biomarker expression profiles. Most serous carcinomas probably arise from the fallopian tube. Clear cell and endometrioid carcinomas are associated with endometriosis and likely originate from ectopic endometrium. The focus of large ovarian cancer screening trials has been detection of macroscopic ovarian abnormalities by ultrasonography and detection of serum biomarkers associated with the most common (serous) subtype of ovarian cancer. The only completed and phase three randomized controlled trial failed to achieve the objective of reducing ovarian cancer mortality and was not able to demonstrate a stage migration effect of the screening. Future screening strategies have to incorporate our growing understanding of each subtype of pelvic (ovarian or fallopian tube) cancer, its organ of origin, and disease-specific biomarkers. We review how our current understanding of pathogenesis should prompt a reexamination of data from ovarian cancer screening studies and discuss potential designs for future screening strategies.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma Early Detection of Cancer Ovarian Neoplasms Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Biomarkers, Tumor Biomarkers, Tumor Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Cystadenocarcinoma, Mucinous Cystadenocarcinoma, Mucinous Cystadenocarcinoma, Mucinous Cystadenocarcinoma, Mucinous

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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