Prospectively detected cancer in familial breast/ovarian cancer screening

Dørum, Anne; Heimdal, Ketil; Løvslett, Kjell; Kristensen, Gunnar B.; Hansen, Lars Jul; Sandvei, Roar; Schiefloe, Arne; Hagen, Bjørn; Himmelmann, Anna; Jerve, F; Shetelig, Kaare; Fjærestad, Ingmar; Tropé, Claes G.; Møller, Pål

doi:10.1034/j.1600-0412.1999.781013.x

Cited by 23 publications

(27 citation statements)

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“…Other ovarian cancer surveillance publications mainly report about patients with one affected family member (breast and/or ovarian cancer) (Bourne et al, 1991;Dorum et al, 1999). Limited data are available regarding women who enrolled in a study strictly on 'high-risk' criteria as shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…This complicates comparisons between the different groups. See Table 6 for an overview of the most recent surveillance studies of high-risk women (TVU, CA-125 with (Dorum et al, 1999;Meeuwissen et al, 2005;Vasen et al, 2005) or without pelvic examination Laframboise et al, 2002;Scheuer et al, 2002;Stirling et al, 2005). Some studies report detection of advanced stage ovarian cancer, while a disappointing low number of patients appeared to have early stage cancer.…”

Section: Discussionmentioning

confidence: 99%

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Surveillance of women at high risk for hereditary ovarian cancer is inefficient

et al. 2006

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To determine the effectiveness of annual gynaecological screening (pelvic examination, transvaginal ultrasound, and CA-125), a prospective cohort study of women at high risk for hereditary ovarian cancer was conducted. Women were offered DNA analysis followed by either annual screening or prophylactic bilateral salpingo-oophorectomy (BSO). Study population consisted of 512 highrisk women (median follow-up 2.07 years, range 0 -9.4 years): 265 women (52%) had a BRCA mutation. Persisting abnormalities indicated diagnostic surgery in 24 women resulting in one primary ovarian cancer FIGO stage IIIc was found. The effectiveness of screening was studied by calculating the probability of finding ovarian cancers in the BRCA-1 and BRCA-2 carrier group and comparing this to the identified number of ovarian cancers. The number of ovarian cancer patients found at surveillance was in accordance with the predicted number of ovarian cancers. A total number of 169 women underwent prophylactic BSO: one ovarian cancer stage IIb was found. In conclusion, the surveillance programme for hereditary ovarian cancer does identify patients with ovarian cancer but is very inefficient considering the high number of surveillance visits and the advanced stage of ovarian cancer in the identified patient. For prevention of advanced stage ovarian cancer, prophylactic BSO from age 35 -40 years is a more efficient alternative.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surveillance of women at high risk for hereditary ovarian cancer is inefficient

et al. 2006

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“…Of the 66 cases of nonmalignant disease, 63 were recognized as not cancer. This result yielded a sensitivity of 100%, specificity of 95% (87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99), and PPV of 94% (101). Although the limitations of this study design and its analysis have been discussed in some detail in the literature (103)(104)(105)(106), the potential implications of such proteomic spectrum analysis for the identification of novel tumor markers is huge.…”

Section: Trials In the Generalmentioning

confidence: 99%

“…Criteria for interpreting the test results vary, and screening protocols are not always clearly reported. Only three of the studies have reported interval cancers, which presented between 2 and 24 months following the last screen (79,86,88). Multifocal peritoneal serous papillary carcinoma may be a phenotypic variant of familial ovarian cancer and screening strategies using ultrasonography and CA125 testing are not reliable in detecting this disease (86,90).…”

Section: Trials In the Generalmentioning

confidence: 99%

Progress and Challenges in Screening for Early Detection of Ovarian Cancer

Jacobs

Menon

2004

Molecular & Cellular Proteomics

421

312

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Ovarian cancer is characterize by few early symptoms, presentation at an advanced stage, and poor survival. As a result, it is the most frequent cause of death from gynecological cancer. During the last decade, a research effort has been directed toward improving outcomes for ovarian cancer by screening for preclinical, early stage disease using both imaging techniques and serum markers. Numerous biomarkers have shown potential in samples from clinically diagnosed ovarian cancer patients, but few have been thoroughly assessed in preclinical disease and screening. The most thoroughly investigated biomarker in ovarian cancer screening is CA125. Prospective studies have demonstrated that both CA125 and transvaginal ultrasound can detect a significant proportion of preclinical ovarian cancers, and refinements in interpretation of results have improved sensitivity and reduced the false-positive rate of screening. There is preliminary evidence that screening can improve survival, but the impact of screening on mortality from ovarian cancer is still unclear. Prospective studies of screening are in progress in both the general population and high-risk population, including the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKC-TOCS), a randomized trial involving 200,000 postmenopausal women designed to document the impact of screening on mortality. Recent advances in technology for the study of the serum proteome offer exciting opportunities for the identification of novel biomarkers or patterns of markers that will have greater sensitivity and lead time for preclinical disease than CA125. Considerable interest and controversy has been generated by initial results utilizing surface-enhanced laser desorption/ionization (SELDI) in ovarian cancer. There are challenging issues related to the design of studies to evaluate SELDI and other proteomic technology, as well as the reproducibility, sensitivity, and specificity of this new technology. Large serum banks such as that assembled in UKCTOCS, which contain preclinical samples from patients who later developed ovarian cancer and other disorders, provide a unique resource for carefully designed studies of proteomic technology. There is a sound basis for optimism that further developments in serum proteomic analysis will provide powerful methods for screening in ovarian cancer and many other diseases.

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“…Hovedårsakene til eggstokkreft er ukjente, men noen risikofaktorer kjenner vi. Arv som hovedfaktor utgjør mellom 5 og 10%, mens resten antas å vaere spontant forekommende tilfeller (6 …”

Section: Innledningunclassified

Tilbakefall av eggstokkreft og borderline tumorer i eggstokkene i Norge

Paulsen¹

2009

Nor J Epidemiol

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ENGLISH SUMMARYPaulsen T. Recurrence of ovarian cancer and borderline ovarian tumours in Norway.Nor J Epidemiol 2001; 11 (2): 143-146. Background:The 5-year relative survival for patients with ovarian cancer in Norway has improved over time, but is still less than 40%. Early diagnosis and optimal therapy can hopefully better the prognosis. In order to improve the techniques of examination, treatment and follow-up of these patients, the establishment of a system for quality insurance of clinical data for cancer in Norway (NOU 20, 1997) has been suggested. According to the answers of a questionnaire that was sent to the gynaecological departments in Norway in the spring of 2000, there were differences in how hospitals handle ovarian cancer patients. Introduction: The age-standardised incidence rate for ovarian cancer has increased from 11.9 per 100 000 person-years in 1957 to 13.3 per 100 000 in 1997. The incidences in the Nordic countries, with the exception of Finland, are among the highest in the world. The borderline ovarian tumours (BOT) had an incidence rate of 4.8 per 100 000 in the period 1970 to 1993. Aim:The main aim of this extended registration of ovarian cancer and BOT in Norway is to better document diagnostic procedures and treatment. We will emphasise the recurrence of ovarian cancer and BOT.Controversies: Only a few prospective protocols have been planned or carried out internationally that were randomised for different treatments of recurrent ovarian cancer. The studies that have been carried out have included only a few patients. In our project we will collect clinical information from the whole population of women with ovarian cancer and BOT in Norway. Surgery of women with recurrence of ovarian cancer in order to achieve tumour reduction is still controversial. Some authors claim that tumour reduction surgery improves the survival of these patients, but this is not proven. Some authors indicate that elderly patients may receive less surgical and chemotherapeutic treatment without obvious clinical rationale. Today we do not know which treatment of recurrence of ovarian cancer gives the longest survival and best quality of life. The incorporation of paclitaxel into first-line therapy improves the duration of progression-free survival and overall survival in women with incompletely-resected stage III and stage IV ovarian cancer. However we do not know which treatment gives the best overall survival in the case of recurrence. BOT are different from the invasive tumours of the ovary, with longer relative 5-year survival. BOT stage I has relative 5-year survival of 99% and for the advanced stages 92%. Probably BOT develop through accumulation of different genetic mutations than invasive epithelial ovarian tumours. Material and method: All women with diagnosed ovarian/tube/perinoneal cancer and BOT as primary disease or recurrence in Norway will be included in this study. About 500 women are diagnosed with ovarian cancer annually and 330 women with recurrence. The number of BOT is approximately 130 p...

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Prospectively detected cancer in familial breast/ovarian cancer screening

Cited by 23 publications

References 0 publications

Surveillance of women at high risk for hereditary ovarian cancer is inefficient

Surveillance of women at high risk for hereditary ovarian cancer is inefficient

Progress and Challenges in Screening for Early Detection of Ovarian Cancer

Tilbakefall av eggstokkreft og borderline tumorer i eggstokkene i Norge

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