Skip to content

Research at St Andrews

Screening for Familial Ovarian Cancer: Failure of Current Protocols to Detect Ovarian Cancer at an Early Stage According to the International Federation of Gynecology and Obstetrics System

Research output: Contribution to journalArticle

DOI

Author(s)

D Stirling, D.G.R Evans, G Pichert, A Shenton, E.N Kirk, S Rimmer, Christopher Michael Steel, S Lawson, R.M.C Busby-Earle, J Walker, FI Lalloo, D.M Eccles, A.M Lucassen, M.E Porteous

School/Research organisations

Abstract

Purpose To assess the effectiveness of annual ovarian cancer screening (transvaginal ultrasound and serum CA-125 estimation) in detecting presymptomatic ovarian cancer in women at increased genetic risk.

Patients and Methods A cohort of 1, 110 women at increased risk of ovarian cancer were screened between January 1991 and March 2004; 553 were moderate-risk individuals (4% to 10% lifetime risk) and 557 were high-risk individuals > 10% lifetime risk). Outcome measurements include the number and stage of screen-detected cancers, the number and stage of cancers not detected at screening, the number of equivocal screening results requiring recall/repetition, and the number of women undergoing surgery for benign disease.

Results Thirteen epithelial ovarian malignancies (12 invasive and one borderline), developed in the cohort. Ten tumors were detected at screening: three International Federation of Gynecology and Obstetrics (FIGO) stage I (including borderline), two stage 11, four stage 111, and one stage IV. Of the three cancers not detected by screening, two were stage III and one was stage IV; 29 women underwent diagnostic surgery but were found not to have ovarian cancer.

Conclusion Annual surveillance by transvaginal ultrasound scanning and serum CA-125 measurement in women at increased familial risk of ovarian cancer is ineffective in detecting tumors at a sufficiently early stage to influence prognosis. With a positive predictive value of 17% and a sensitivity of less than 50%, the performance of ultrasound does not satisfy the WHO screening standards. In addition, the combined protocol has a particularly high false-positive rate in premenopausal women, leading to unnecessary surgical intervention.

Close

Details

Original languageEnglish
Pages (from-to)5588-5596
Number of pages9
JournalJournal of Clinical Oncology
Volume23
Issue number24
DOIs
Publication statusPublished - 20 Aug 2005

    Research areas

  • BREAST-CANCER, MUTATION CARRIERS, WOMEN, RISK, BRCA1, OOPHORECTOMY, CARCINOMA, SURVIVAL, POPULATION, ULTRASOUND

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Why do women not return family history forms when referred to breast cancer genetics services? A mixed-method study

    Hanning, K., Steel, C. M., Goudie, D., McLeish, L., Dunlop, J., Myring, J., Sullivan, F., Berg, J., Humphris, G. M. & Ozakinci, G., Oct 2015, In : Health Expectations. 18, 5, p. 1735-1743

    Research output: Contribution to journalArticle

  2. Surveillance for familial breast cancer: Differences in outcome according to BRCA mutation status

    Moller, P., Evans, DG., Reis, MM., Gregory, H., Anderson, E., Maehle, L., Lalloo, F., Howell, A., Apold, J., Clark, N., Lucassen, A. & Steel, C. M., 1 Sep 2007, In : International Journal of Cancer. 121, 5, p. 1017-1020 4 p.

    Research output: Contribution to journalArticle

  3. Monitoring phyto-oestrogen exposure in patients with breast cancer after diagnosis

    Gilmour, A., Ritchie, M. R., Mackinnon, L. J., Wong, V., Charlton, C., Steel, C. M., Gates, S. E. E., Smith, J. & Gibbs, T. J., 2007, In : Proceedings of the Nutrition Society . 66, p. 31A-31A 1 p.

    Research output: Contribution to journalArticle

  4. Analysis of referrals to a multi-disciplinary breast cancer genetics clinic: practical and economic considerations

    Reis, M. M., Young, D., McLeish, L., Goudie, D., Cook, A., Sullivan, F., Vysny, H., Fordyce, A., Black, R., Tavakoli, M. & Steel, M., Nov 2006, In : Familial Cancer. 5, 4, p. 297-303 7 p.

    Research output: Contribution to journalArticle

Related by journal

  1. Effect of psychological intervention on fear of cancer recurrence: a systematic review and meta-analysis

    Tauber, N. M., O'Toole, M. S., Dinkel, A., Galica, J., Humphris, G., Lebel, S., Maheu, C., Ozakinci, G., Prins, J., Sharpe, L., Smith, A. B., Thewes, B., Simard, S. & Zachariae, R., 18 Sep 2019, In : Journal of Clinical Oncology. 37, 18 p.

    Research output: Contribution to journalReview article

  2. New model for estimating glomerular filtration rate in patients with cancer

    Janowitz, T., Williams, E. H., Marshall, A., Ainsworth, N., Thomas, P. B., Sammut, S. J., Shepherd, S., White, J., Mark, P. B., Lynch, A. G., Jodrell, D. I., Tavaré, S. & Earl, H., Aug 2017, In : Journal of Clinical Oncology. 35, 24, p. 2798-2805 10 p.

    Research output: Contribution to journalArticle

  3. The effect of sunitinib on biomarkers and tumor heterogeneity in metastatic clear cell renal cancer.

    Stewart, G., Laird, A., O'Mahony, F., Eory, L., Lubbock, A., Nanda, J., O'Donnell, M., Mackay, A., Mullen, P., McNeill, A., Riddick, A., Aitchison, M., Berney, D., Bex, A., Overton, I., Harrison, D. J. & Powles, T., 1 Feb 2014, In : Journal of Clinical Oncology. 32, 4, 1 p.

    Research output: Contribution to journalAbstract

  4. Importance of long-term follow-up of women receiving adjuvant therapy for breast cancer in the community

    Mccowan, C., Dewar, J. A. & Thompson, A. M., 1 Sep 2011, In : Journal of Clinical Oncology. 29, 25, p. 3492-3492 1 p.

    Research output: Contribution to journalArticle

ID: 352203

Top