Transvaginal Sonographic Screening May Catch Ovarian Cancer Early

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NEW YORK (Reuters Health) May 28 - Transvaginal sonography (TVS) screening is associated with a reduction in ovarian cancer stage at detection and with increased case-specific survival, new research shows. However, TVS screening is not helpful in diagnosing ovarian malignancies in women with normal ovarian volumes.

Ovarian cancer is known to be the most deadly of all gynecologic malignancies, due in large part to its typically advanced stage at diagnosis. Therefore, early detection of this cancer could potentially improve treatment efficacy and reduce mortality.

In the present study, Dr. John R. van Nagell, from the University of Kentucky in Lexington, and colleagues assessed the value of annual TVS screening in 25,327 women who were seen between 1987 and 2005. To be eligible for the study, the subjects had to be at least 50 years of age with no cancer-related symptoms or at least 25 years of age with a family history of ovarian cancer.

The researchers' findings appear in the May 1st issue of Cancer.

Overall, 364 women (1.4%) had a persistent ovarian tumor on TVS, the report indicates. Malignant cases included 35 primary invasive ovarian cancers, 9 serous ovarian tumors of low malignant potential, and 7 metastatic cancers. Of the non-metastatic cases, 28 were stage I disease, 8 were stage II, and 8 were stage III.

During a mean follow-up period of 5.3 years, 38 patients were alive and well, 4 had died of their malignancy, and 2 had died from other causes. The 2- and 5-year survival rates in annually screened patients, excluding those with nonepithelial or borderline ovarian cancers, were 89.9% and 77.2%, respectively.

TVS screening was 85.0% sensitive and 98.7% specific in detecting ovarian cancer with positive and negative predictive values of 14.0% and 99.9%, respectively. False-negative results were obtained in nine women, including three who died of their disease, the investigators note.

"The protective effect of annual sonographic screening on ovarian cancer mortality observed in the current trial should only increase as more specific biomarkers are added to TVS in screening algorithms," the researchers conclude.

Cancer 2007;109:1887-1896.

Source: http://www.medscape.com/viewarticle/557355?src=mp