Screening for ovarian cancer: The preliminary experience of a familial ovarian cancer center

Michael G. Muto, Daniel W. Cramer, Douglas L. Brown, William R. Welch, Bernard L. Harlow, Huijuan Xu, Judy P. Brucks, Sai Wah Tsao, Ross S. Berkowitz

Research output: Contribution to journalArticlepeer-review

67 Scopus citations

Abstract

Women with a family history of ovarian cancer represent a high-risk group for the development of epithelial ovarian cancer. From July 1990 through December 1992, 386 women with a first-degree or multiple second-degree relatives with confirmed ovarian cancer were enrolled in a study to assess the utility of screening with transvaginal sonography, color flow doppler, and CA125. The mean age of the group was 41: 85% were premenopausal and 89/384 (23%) had 2 or more relatives with ovarian cancer. An initial ultrasound examination was abnormal in 89/384 (23%), 89% of whom were premenopausal. A persistent ovarian mass was detected in 15 patients and all were surgically proven to be benign. Mean CA125 levels were significantly higher and more variable in pre- vs postmenopausal women. CA125 was ≥35 U/ml in 42/386 (11%) (36-232 U/ml). All but one of these women were premenopausal and 50% subsequently normalized. Two patients who were surgically explored for a rising CA125 had normal ovaries. An additional 19 patients have undergone prophylactic oophorectomy with no consistent histopathologic abnormality identified. These data demonstrate the difficulty inherent in screening a predominantly premenopausal population and do not clearly establish the efficacy of these modalities in the early detection of ovarian cancer.

Original languageEnglish (US)
Pages (from-to)12-20
Number of pages9
JournalGynecologic oncology
Volume51
Issue number1
DOIs
StatePublished - Oct 1993

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