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BMJ. 1993 Apr 17;306(6884):1025-9.

Screening for early familial ovarian cancer with transvaginal ultrasonography and colour blood flow imaging.

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  • 1Department of Obstetrics and Gynaecology, King's College School of Medicine and Dentistry, London.

Abstract

OBJECTIVE:

To assess the value of transvaginal ultrasonography with colour blood flow imaging in detecting early ovarian cancer in women with a family history of the disease.

DESIGN:

Study of self referred symptomless women with a close relative who had developed the disease. Each woman was screened to detect persistent lesions and defined changes in ovarian volume. Morphological score and pulsatility index were recorded.

SETTING:

Ovarian screening clinic.

SUBJECTS:

1601 self referred women.

INTERVENTIONS:

Women with a positive screening result were recommended to have further investigations.

MAIN OUTCOME MEASURES:

Findings at surgery and histology of abnormal ovaries. Morphological score > or = 5 and pulsatility index < 1.0 at last scan.

RESULTS:

Women were aged 17 to 79 (mean 47) years; 959 (60%) were premenopausal, 469 (29%) were naturally postmenopausal, and 173 (11%) had had a hysterectomy. 157 women had a pedigree suggestive of the site specific ovarian cancer syndrome and 288 of multiple site cancers. 61 women had a positive screening result (3.8%, 95% confidence interval 2.9 to 4.9%), six of whom had primary ovarian cancer detected at surgery (five stage Ia, one stage III). Use of a high morphological score or a low pulsatility index increased the odds of finding ovarian cancer from 1:9 to about 2:5 (1:1 in the highest risk groups). Five interval cancers were reported (three ovarian and two peritoneal). Eight of the 11 cancers developed in women with pedigrees suggestive of inherited cancer.

CONCLUSIONS:

Transvaginal ultrasonography with colour flow imaging can effectively detect early ovarian cancer in women with a family history of the disease. The screening interval should be less than two years.

PMID:
8490496
[PubMed - indexed for MEDLINE]
PMCID:
PMC1677026
Free PMC Article
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