Ovarian cancer screening with annual transvaginal sonography

Abstract

BACKGROUNDOvarian cancer has the highest mortality rate of all gynecologic malignancies, and most women present with advanced‐stage disease. The current investigation was performed to determine the efficacy of annual transvaginal sonography (TVS) as a screening method for ovarian cancer.METHODSAnnual TVS screening was performed on 25,327 women from 1987 to 2005. Asymptomatic women aged ≥50 years and women aged ≥25 years who had a family history of ovarian cancer were eligible for participation in this trial.RESULTSAmong 364 patients (1.4%) with a persisting ovarian tumor on TVS who underwent exploratory laparoscopy or laparotomy with tumor removal, 35 primary invasive ovarian cancers, 9 serous ovarian tumors of low malignant potential, and 7 cancers metastatic to the ovary were detected. Stage distribution was as follows: 28 patients had stage I disease, 8 patients had stage II disease, and 8 patients had stage III disease. Four patients died of disease, 2 patients died of other causes, and 38 patients were alive and well from 0.5 years to 15.8 years after diagnosis (mean, 5.3 years). Nine women developed ovarian cancer within 12 months of a negative screen (false‐negative results), and 3 of these patients died of disease. TVS screening had a sensitivity of 85.0%, specificity of 98.7%, positive predictive value of 14.01%, and negative predictive value of 99.9%. After 107,276 screening years, there have been 7 ovarian cancer deaths in the annually screened population and 3 ovarian cancer deaths among women who were noncompliant. Excluding patients with nonepithelial or borderline ovarian malignancies, the survival of patients with ovarian cancer in the annually screened population was 89.9% ± 10.1% at 2 years and 77.2% ± 22.8% at 5 years.CONCLUSIONSTVS screening, when it was performed annually, was associated with a decrease in disease stage at detection and with case‐specific ovarian cancer mortality, but it was not effective in detecting ovarian cancers in women who had normal ovarian volume. Cancer 2007; © 2007 American Cancer Society.

Role of Ultrasound in Characterization of Ovarian Masses

“…Furthermore, we would have to perform multiple studies prospectively on a larger scale with larger patient population to assess the reliability of both forms of imaging, that is, color Doppler and grey scale imaging independently as well as concurrently with a predefined criteria in determining the diagnosis of ovarian masses (Van Nagell et al, 2007). Knowledge of the exact nature of a pelvic mass after ultrasound examination is also a prerequisite for effective management, surgical or non-surgical.…”

Hypodontia and ovarian cancer: A systematic review

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Ovarian tumours, their characterisation and origins and ovarian screening

“…One of the longer running series has been in Kentucky, USA, which started in 1987, used annual transvaginal ultrasound scanning and continued until 2005 (DePriest andDeSimone 2003;van Nagell et al 2007). A total of 25,327 women underwent screening and 364 (1.4%) had persisting ovarian abnormality; these women underwent CA125 estimation, tumour morphology indexing (ovarian volume, cyst wall and septation) and Doppler fl ow sonography, prior to laparoscopy or laparotomy.…”