Hereditary Cancer in Clinical Practice (Nov 2011)

Screening for ovarian cancer in women with varying levels of risk, using annual tests, results in high recall for repeat screening tests

  • Nobbenhuis Marielle AE,
  • Bancroft Elizabeth,
  • Moskovic Eleanor,
  • Lennard Fiona,
  • Pharoah Paul,
  • Jacobs Ian,
  • Ward Ann,
  • Barton Desmond PJ,
  • Ind Thomas EJ,
  • Shepherd John H,
  • Bridges Jane E,
  • Gore Martin,
  • Haracopos Chris,
  • Shanley Susan,
  • Ardern-Jones Audrey,
  • Thomas Sarah,
  • Eeles Ros

DOI
https://doi.org/10.1186/1897-4287-9-11
Journal volume & issue
Vol. 9, no. 1
p. 11

Abstract

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Abstract Background We assessed ovarian cancer screening outcomes in women with a positive family history of ovarian cancer divided into a low-, moderate- or high-risk group for development of ovarian cancer. Methods 545 women with a positive family history of ovarian cancer referred to the Ovarian Screening Service at the Royal Marsden Hospital, London from January 2000- December 2008 were included. They were stratified into three risk-groups according to family history (high-, moderate- and low-risk) of developing ovarian cancer and offered annual serum CA 125 and transvaginal ultrasound screening. The high-risk group was offered genetic testing. Results The median age at entry was 44 years. The number of women in the high, moderate and low-risk groups was 397, 112, and 36, respectively. During 2266 women years of follow-up two ovarian cancer cases were found: one advanced stage at her fourth annual screening, and one early stage at prophylactic bilateral salpingo-oophorectomy (BSO). Prophylactic BSO was performed in 138 women (25.3%). Forty-three women had an abnormal CA125, resulting in 59 repeat tests. The re-call rate in the high, moderate and low-risk group was 14%, 3% and 6%. Equivocal transvaginal ultrasound results required 108 recalls in 71 women. The re-call rate in the high, moderate, and low-risk group was 25%, 6% and 17%. Conclusion No early stage ovarian cancer was picked up at annual screening and a significant number of re-calls for repeat screening tests was identified.

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