Results of annual screening in phase I of the United Kingdom familial ovarian cancer screening study highlight the need for strict adherence to screening schedule.

Abstract

PURPOSE:

To establish the performance characteristics of annual transvaginal ultrasound and serum CA125 screening for women at high risk of ovarian/fallopian tube cancer (OC/FTC) and to investigate the impact of delayed screening interval and surgical intervention.

PATIENTS AND METHODS:

Between May 6, 2002, and January 5, 2008, 3,563 women at an estimated ≥ 10% lifetime risk of OC/FTC were recruited and screened by 37 centers in the United Kingdom. Participants were observed prospectively by centers, questionnaire, and national cancer registries.

RESULTS:

Sensitivity for detection of incident OC/FTC at 1 year after last annual screen was 81.3% (95% CI, 54.3% to 96.0%) if occult cancers were classified as false negatives and 87.5% (95% CI, 61.7% to 98.5%) if they were classified as true positives. Positive and negative predictive values of incident screening were 25.5% (95% CI, 14.3 to 40.0) and 99.9% (95% CI, 99.8 to 100) respectively. Four (30.8%) of 13 incident screen-detected OC/FTCs were stage I or II. Compared with women screened in the year before diagnosis, those not screened in the year before diagnosis were more likely to have ≥ stage IIIc disease (85.7% v 26.1%; P = .009). Screening interval was delayed by a median of 88 days before detection of incident OC/FTC. Median interval from detection screen to surgical intervention was 79 days in prevalent and incident OC/FTC.

CONCLUSION:

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

• Authors: Adam N Rosenthal, Lindsay Fraser, Ranjit Manchanda, Philip Badman, Susan Philpott, Jessica Mozersky, Richard Hadwin, Fay H Cafferty, Elizabeth Benjamin, Naveena Singh, D Gareth Evans, Diana M Eccles, Steven J Skates, James Mackay, Usha Menon, Ian J Jacobs
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 31 Issue 1 Pg. 49-57 (Jan 01 2013) ISSN: 1527-7755 [Electronic] United States
• PMID: 23213100 (Publication Type: Clinical Trial, Phase I, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Ovarian Epithelial
• Early Detection of Cancer (standards)
• Fallopian Tube Neoplasms (diagnosis, genetics, prevention & control)
• Female
• Follow-Up Studies
• Genetic Predisposition to Disease
• Guideline Adherence
• Humans
• Mass Screening (standards)
• Middle Aged
• Neoplasm Grading
• Neoplasm Staging
• Neoplasms, Glandular and Epithelial (diagnosis, genetics, prevention & control)
• Ovarian Neoplasms (diagnosis, genetics, prevention & control)
• Peritoneal Neoplasms (diagnosis, genetics, prevention & control)
• Prognosis
• Prospective Studies
• United Kingdom