Update on ovarian cancer pathogenesis: history, controversies, emerging issues and future impact

Among American women, the most common cause of death from gynecologic malignancy is ovarian cancer. With the discovery and publicizing of hereditary cancer gene mutations, patients are actively seeking their physician’s advice on how to manage risk. As a cancer prevention measure, risk-reducing surgery has become a popular procedure. Based on studies of salpingo-oophorectomies from BRCA-positive women, the fallopian tube has been put forth as the cause of high-grade ovarian cancer. More recently, ovarian surface hilar stem cells have been suggested as the putative cells of origin. In this exciting time of new thinking about its origins, we stand on the threshold of new and promising strategies for more precise management of ovarian cancer patients.