Ultrasound screening for familial ovarian cancer

Bourne, T.H.; Whitehead, MI; Campbell, Sukhkamal; Royston, Patrick; Bhan, V.; Collins, WP

doi:10.1016/0020-7292(92)91043-n

Cited by 18 publications

(23 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%

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%

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

et al. 2006

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“…Statistical evaluation of screening data indicates that the frequency of benign ovarian tumors is increased in patients with a family history of ovarian cancer. 6 In addition, transition from benign to borderline or malignant epithelium has been documented in both serous and mucinous ovarian neoplasm^. ',^ In one study, it was demonstrated that there was a histologic transition from benign to malignant epithelium in 46% of serous cystadenocarcinomas and 33% of mucinous cystadenocarcinomas.8 These preliminary data support the concept that certain serous or mucinous cystadenomas have the potential to undergo malignant transformation.…”

Section: Screening Characteristicsmentioning

confidence: 90%

“…For example, the prevalence of ovarian cancer in England increased from 40 per 100,000 in the general population to 390 per 100,000 in women with a documented history of ovarian cancer in a first-degree or second-degree relative. 6 Recently, there has been increasing evidence to suggest that there is a preclinical phase in ovarian cancer. Statistical evaluation of screening data indicates that the frequency of benign ovarian tumors is increased in patients with a family history of ovarian cancer.…”

Section: Screening Characteristicsmentioning

confidence: 99%

Ovarian cancer screening

Nagell

DePriest

Gallion

et al. 1993

Cancer

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Background. Despite advances in evaluation and treatment, ov'arian cancer mortality has decreased minimally during the past two decades. Most patients have advanced-stage disease at diagnosis, and the prognosis is poor. As a result, there has been increasing interest in the development of methods for the early detection of ovarian cancer. To benefit from screening, a disease should (1) be a significant cause of mortality, (2) have a high prevalence in the screened population, (3) have a preclinical phase that can be detected by screening, and (4) be amenable to therapy, such that the survival rate of patients with early-stage disease is significantly higher than that of patients with advanced-stage disease. Ovarian cancer fulfills all of these criteria.Methods. An optimal screening method should be safe, easy to do, time efficient, and acceptable to the patients being screened. Most importantly, it should have a high sensitivity and specificity.Results. Currently, the most effective screening methods for ovarian cancer are serum CA 125 levels and transvaginal sonography (TVS). In screening studies, the serum CA 125 level has had a reasonably high specificity but a low sensitivity. Currently, approximately 8000 asymptomatic women have been screened with TVS. Ten primary ovarian cancers were detected, and all were Stage I lesions. Patients whose tumors were detected by TVS all have been cured by conventional treatment. TVS screening has resulted in a significant reduction in stage at detection and in the case-specific death rate from ovarian cancer. In these studies, TVS has had a high sensitivity but only a moderate specificity. CA 125 level, Doppler flow sonography, and the use of a morphology index are being evaluated as methods to increase the specificity of TVS.Conclusions. A large multiinstitutional study is indicated to determine if annual TVS screening will cause a

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“…Currently, approximately 16,500 women have been screened by ultrasonography, and 18 primary stage-I ovarian cancers have been detected [7][8][9][10]. Data collected from recent studies of ultrasound accuracy in the prediction of malignancy gave an average sensitivity of 88% [11].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Oophorectomy in Asymptomatic Women over 50 Years Old Selected by Ovarian Cancer Screening

Hayashi

Yaginuma

Kitamura

et al. 1999

Gynecol Obstet Invest

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The purpose of this study was to evaluate bilateral oophorectomy in women over 50 years old found to have an adnexal mass using transvaginal ultrasonography (TVS) as a mass screening. With TVS a total of 23,451 women without symptoms were examined for ovarian cancer at annual screening for uterine cervical cancer. Two hundred fifty-eight women over 50 years old persistently had abnormal TVS results and 95 women gave informed consent for surgical tumor removal. In the 95 women operated, 7 malignant ovarian cancers were found. Especially adnexal masses which were thought to be benign were treated by laparoscopic surgery.

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Ultrasound screening for familial ovarian cancer

Cited by 18 publications

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

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

Ovarian cancer screening

Bilateral Oophorectomy in Asymptomatic Women over 50 Years Old Selected by Ovarian Cancer Screening

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