Results from an ultrasound‐based familial ovarian cancer screening clinic: a 10‐year observational study

Tailor, Anil; Bourne, Tom; Campbell, Stuart; Okokon, E Jude; Dew, Tracy; Collins, W. P.

doi:10.1002/uog.65

Cited by 46 publications

(35 citation statements)

References 23 publications

(26 reference statements)

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“…TVU and serum CA125 lack adequate sensitivity apart or together (15 -71% for TVU/CA125) (Laframboise et al, 2002;Scheuer et al, 2002;Tailor et al, 2003;Meeuwissen et al, 2005;Stirling et al, 2005;Olivier et al, 2006) and our finding of 42% for TVU/CA125 is in accordance with these findings.…”

Section: Discussionsupporting

confidence: 92%

No efficacy of annual gynaecological screening in BRCA1/2 mutation carriers; an observational follow-up study

et al. 2007

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BRCA1/2 mutation carriers are offered gynaecological screening with the intention to reduce mortality by detecting ovarian cancer at an early stage. We examined compliance and efficacy of gynaecological screening in BRCA1/2 mutation carriers. In this multicentre, observational, follow-up study we examined medical record data of a consecutive series of 888 BRCA1/2 mutation carriers who started annual screening with transvaginal ultrasonography and serum CA125 between 1993 and 2005. The women were annually screened for 75% of their total period of follow-up. Compliance decreased with longer follow-up. Five of the 10 incident cancers were interval tumours, diagnosed in women with a normal screening result within 3–10 months before diagnosis. No difference in stage distribution between incident screen-detected and interval tumours was found. Eight of the 10 incident cancers were stage III/IV (80%). Cancers diagnosed in unscreened family members had a similar stage distribution (77% in stage III/IV). The observed number of cases detected during screening was not significantly higher than expected (Standardized Incidence Ratio (SIR): 1.5, 95% confidence interval: 0.7–2.8). For the subgroup that was fully compliant to annual screening, a similar SIR was found (1.6, 95% confidence interval: 0.5–3.6). Despite annual gynaecological screening, a high proportion of ovarian cancers in BRCA1/2 carriers are interval cancers and the large majority of all cancers are diagnosed in advanced stages. Therefore, it is unlikely that annual screening will reduce mortality from ovarian cancer in BRCA1/2 mutation carriers.

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Section: Discussionsupporting

confidence: 92%

No efficacy of annual gynaecological screening in BRCA1/2 mutation carriers; an observational follow-up study

et al. 2007

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“…Remarkably, only two of the studies cited in Table 6 reported interval cancers. Conversely, in other studies patients with a lower risk of ovarian cancer based on the family history were faced with interval ovarian cancers (van Nagell et al, 2000;Tailor et al, 2003). Stirling et al (2005) annually screened 1,110 high-risk women and only found two early stage (stage I) ovarian cancers.…”

Section: Discussionmentioning

confidence: 96%

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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“…At present, there are two screening tests for ovarian cancer: serologic screening for tumor antigen using cancer antigen-125 (CA-125), and imaging using transvaginal sonography (2)(3)(4)(5)(6). However, with a cutoff of 30 to 35 units/mL, serum CA-125 has been shown to have a sensitivity of only 50% to 60% with the specificity of >98%, for early-stage disease (4,7,8).…”

Section: Introductionmentioning

confidence: 99%

“…However, with a cutoff of 30 to 35 units/mL, serum CA-125 has been shown to have a sensitivity of only 50% to 60% with the specificity of >98%, for early-stage disease (4,7,8). Transvaginal sonography alone or combined with Doppler and morphologic indices, are only sensitive and specific for established tumors, and are, therefore, not suitable for early diagnostics of ovarian cancer (6,9). Recently, a novel technology, surface-enhanced laser desorption/ionization time-of-flight mass spectrometry has been offered for early detection of ovarian cancer (10).…”

Section: Introductionmentioning

confidence: 99%

Multiplexed Immunobead-Based Cytokine Profiling for Early Detection of Ovarian Cancer

Gorelik

Landsittel

Marrangoni

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

241

164

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Early detection of ovarian cancer might improve clinical outcome. Some studies have shown the role of cytokines as a new group of tumor markers for ovarian cancer. We hypothesized that a panel comprised of multiple cytokines, which individually may not show strong correlation with the disease, might provide higher diagnostic power. To evaluate the diagnostic utility of cytokine panel, we used a novel multianalyte LabMAP profiling technology that allows simultaneous measurement of multiple markers. Concentrations of 24 cytokines (cytokines/chemokines, growth, and angiogenic factors) in combination with cancer antigen-125 (CA-125), were measured in sera of 44 patients with earlystage ovarian cancer, 45 healthy women, and 37 patients with benign pelvic tumors. Six markers, i.e., interleukin (IL)-6, IL-8, epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), and CA-125, showed significant differences in serum concentrations between ovarian cancer and control groups. Out of this group, IL-6, IL-8, VEGF, EGF, and CA-125, were used in a classification tree analysis that resulted in 84% sensitivity at 95% specificity. The receiver operator characteristic curve created using the combination of markers produced sensitivities between 90% and 100% in the area of 80% to 90% specificity, whereas the receiver operator characteristic curve for CA-125 alone resulted in sensitivities of 70% to 80%. The classification tree analysis for discrimination of benign condition from ovarian cancer used CA-125, granulocyte colony-stimulating factor (G-CSF), IL-6, EGF, and VEGF resulting in 86.5% sensitivity and 93.0% specificity. The presented data show that simultaneous testing of a panel of serum cytokines and CA-125 using LabMAP technology may present a promising approach for ovarian cancer detection.

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Results from an ultrasound‐based familial ovarian cancer screening clinic: a 10‐year observational study

Abstract: Objectives

Cited by 46 publications

References 23 publications

No efficacy of annual gynaecological screening in BRCA1/2 mutation carriers; an observational follow-up study

No efficacy of annual gynaecological screening in BRCA1/2 mutation carriers; an observational follow-up study

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

Multiplexed Immunobead-Based Cytokine Profiling for Early Detection of Ovarian Cancer

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