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Ovarian cancer family and prophylactic choices.

With reference to the case report by Evans et al (J Med Genet 1992;29:416-8), we would like to point out that in the pedigree presented it is incorrect to describe the 'risk' of ovarian cancer as 50% in first, 25% in second, and 12-5% in third degree relatives of affected persons. These percentages actually refer to the probability of women inheriting a liability to develop cancer rather than risk. The penetrance of the putative familial ovarian and breast cancer gene(s) is unlikely to be 100% and in our published segregation analysis' the lifetime penetrance was between 0 74 and 0 79. Thus, only 70 to 80% of gene carriers will be expected to develop the disease. The genetic risk R, for relatives at age j is given by2: