Strict Ovarian CA Screening Adherence Called for in High-Risk

In high-risk patients, even with annual screening, incident cancers are rarely early-stage

WEDNESDAY, Dec. 5 (HealthDay News) -- For women at higher risk for ovarian and/or fallopian tube cancer (OC/FTC), annual screening offers high sensitivity for detection of incident cancers, but few of these cancers are stage I or II, according to research published online Dec. 3 in the Journal of Clinical Oncology.

Between 2002 and 2008, Adam N. Rosenthal, M.D., Ph.D., of Barts and the London School of Medicine and Dentistry, and colleagues screened 3,563 women who were estimated to be at a 10 percent or higher lifetime risk of OC/FTC. Women were evaluated using transvaginal ultrasound and serum CA125 screening and followed prospectively.

The researchers found that, at one year after the last annual screening, the sensitivity for detection of incident OC/FTC was 81.3 or 87.5 percent if occult cancers were classified as false negatives or true positives, respectively. For incident screening, the positive and negative predictive values were 25.5 and 99.9 percent, respectively. There were 13 incident screen-detected cases of OC/FTC; only four of these were stage I or II. Women who were not screened in the year before diagnosis were significantly more likely to have stage IIIc disease or higher compared with those who had been screened the year before (85.7 versus 26.1 percent). In prevalent and incident cancer, the median time between detection screen and surgical intervention was 79 days.

"These results in the high-risk population highlight the need for strict adherence to [a] screening schedule," the authors write. "Screening more frequently than annually, with prompt surgical intervention, seems to offer a better chance of early-stage detection."

Several authors disclosed financial ties to medical and diagnostic technology companies.

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