Ovarian cancer screening

Usha Menon

doi:10.1503/cmaj.1031298

Ovarian cancer screening

Usha Menon

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2004 · vol. 171(4) , pp. 323–4 · doi:10.1503/cmaj.1031298 · PMID:15313987 · PMC509040

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This paper reviews ovarian cancer screening strategies, including ultrasound alone and multimodal screening with CA125 and ultrasound, and discusses their effectiveness in early detection and improving survival rates.

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This review evaluates the efficacy of screening strategies for ovarian cancer, comparing transvaginal ultrasonography alone against a multimodal approach using CA125 serum markers followed by ultrasound. The authors note that while multimodal screening improves specificity and positive predictive value, it has not yet demonstrated a significant reduction in mortality rates compared to no screening, raising concerns about unnecessary surgeries due to false positives. The paper explicitly mentions endometriosis as one of the benign conditions that can cause elevated CA125 levels, thereby reducing the marker's specificity for detecting malignancy. Relevance to endometriosis: listed as a benign condition causing false-positive CA125 results, though the paper's main focus is ovarian cancer screening.

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Results

may be years away. In women at risk for familial ovar- ian cancer, screening is an op- tion. However, clinicians should ensure that these women are counselled about the alternative of having primary salpingo- oophorectomy. Usha Menon Senior Lecturer / Consultant Gynaecology Cancer Research Centre Department of Gynaecological Oncology Institute of Women’s Health University College London London, UK

References

1. Valentin L. Use of morphology to characterize and manage common ad- nexal masses. Best Pract Res Clin Obstet Gynaecol2004;18(1):71-89. 2. Timmerman D. The use of mathe- matical models to evaluate pelvic masses: Can they beat an expert oper- ator? Best Pract Res Clin Obstet Gy- naecol2004;18(1):91-104. 3. Bailey CL, Ueland FR, Land GL, DePriest PD, Gallion HH, Kryscio RJ, et al. The malignant potential of small cystic ovarian tumors in women over 50 years of age. Gynecol Oncol 1998;69(1):3-7. 4. Roman LD. Small cystic pelvic masses in older women: Is surgical removal necessary? Gynecol Oncol 1998;69(1):1-2. 5. Valentin L, Skoog L, Epstein E. Fre- quency and type of adnexal lesions in autopsy material from postmenopausal women: ultrasound study with histo- logical correlation. Ultrasound Obstet Gynecol 2003;22(3):284-9. 6. Skates SJ, Menon U, MacDonald N, Rosenthal AN, Oram DH, Knapp RC, et al. Calculation of the risk of ovarian cancer from serial CA-125 values for preclinical detection in postmenopausal women. J Clin Oncol 2003;21(10 Suppl):206-10. 7. Lewis S, Menon U. Screening for ovarian cancer. Expert Rev Anticancer Ther2003;3(1):55-62. 8. Jacobs IJ, Skates SJ, MacDonald N, Menon U, Rosenthal AN, Davies AP, et al. Screening for ovarian cancer: a pilot randomised controlled trial. Lancet1999;353(9160):1207-10. 9. Sato S, Yokoyama Y, Sakamoto T, Futagami M, Saito Y. Usefulness of mass screening for ovarian carcinoma using transvaginal ultrasonography. Cancer2000;89(3):582-8. 10. Van Nagell JR Jr, DePriest PD, Reedy MB, Gallion HH, Ueland FR, Pavlik EJ, et al. The efficacy of transvaginal sonographic screening in asympto- matic women at risk for ovarian can- cer. Gynecol Oncol2000;77(3):350-6. 11. Hasson MA, Fagerstrom RM, Kahane DC, Walsh JH, Myers MH, Caughman C, et al; Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial Project Team. Design and evolution of the data management systems in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Control Clin Trials2000;21(6 Suppl):329S-348S. 12. Screening for ovarian cancer: recom- mendation statement. Ann Fam Med 2004;2(3):260-2. ANALYSIS 324 JAMC 17 AOÛT 2004; 171 (4) © 2004 Canadian Medical Association or its licensors

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MeSH descriptors

Biomarkers, Tumor Mass Screening Ovarian Neoplasms Ovarian Neoplasms Proteins Biomarkers, Tumor Female Humans Intracellular Signaling Peptides and Proteins Mass Screening Ovarian Neoplasms Proteins Ultrasonography

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