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. 1993 Apr 17;306(6884):1025–1029. doi: 10.1136/bmj.306.6884.1025

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

T H Bourne 1, S Campbell 1, K M Reynolds 1, M I Whitehead 1, J Hampson 1, P Royston 1, T J Crayford 1, W P Collins 1
PMCID: PMC1677026  PMID: 8490496

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.

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Selected References

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  1. Bhan V., Amso N., Whitehead M. I., Campbell S., Royston P., Collins W. P. Characteristics of persistent ovarian masses in asymptomatic women. Br J Obstet Gynaecol. 1989 Dec;96(12):1384–1391. doi: 10.1111/j.1471-0528.1989.tb06299.x. [DOI] [PubMed] [Google Scholar]
  2. Booth M., Beral V., Smith P. Risk factors for ovarian cancer: a case-control study. Br J Cancer. 1989 Oct;60(4):592–598. doi: 10.1038/bjc.1989.320. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bourne T. H., Campbell S., Steer C. V., Royston P., Whitehead M. I., Collins W. P. Detection of endometrial cancer by transvaginal ultrasonography with color flow imaging and blood flow analysis: a preliminary report. Gynecol Oncol. 1991 Mar;40(3):253–259. doi: 10.1016/0090-8258(90)90287-u. [DOI] [PubMed] [Google Scholar]
  4. Bourne T. H., Hampson J., Reynolds K., Collins W. P., Campbell S. Screening for early ovarian cancer. 1992 Oct 21-Nov 3Br J Hosp Med. 48(8):454–459. [PubMed] [Google Scholar]
  5. Bourne T. H., Whitehead M. I., Campbell S., Royston P., Bhan V., Collins W. P. Ultrasound screening for familial ovarian cancer. Gynecol Oncol. 1991 Nov;43(2):92–97. doi: 10.1016/0090-8258(91)90051-6. [DOI] [PubMed] [Google Scholar]
  6. Bourne T., Campbell S., Steer C., Whitehead M. I., Collins W. P. Transvaginal colour flow imaging: a possible new screening technique for ovarian cancer. BMJ. 1989 Dec 2;299(6712):1367–1370. doi: 10.1136/bmj.299.6712.1367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Campbell S., Bhan V., Royston P., Whitehead M. I., Collins W. P. Transabdominal ultrasound screening for early ovarian cancer. BMJ. 1989 Dec 2;299(6712):1363–1367. doi: 10.1136/bmj.299.6712.1363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Campbell S., Royston P., Bhan V., Whitehead M. I., Collins W. P. Novel screening strategies for early ovarian cancer by transabdominal ultrasonography. Br J Obstet Gynaecol. 1990 Apr;97(4):304–311. doi: 10.1111/j.1471-0528.1990.tb01806.x. [DOI] [PubMed] [Google Scholar]
  9. Granberg S., Norström A., Wikland M. Tumors in the lower pelvis as imaged by vaginal sonography. Gynecol Oncol. 1990 May;37(2):224–229. doi: 10.1016/0090-8258(90)90337-k. [DOI] [PubMed] [Google Scholar]
  10. Hata K., Makihara K., Hata T., Takahashi K., Kitao M. Transvaginal color Doppler imaging for hemodynamic assessment of reproductive tract tumors. Int J Gynaecol Obstet. 1991 Dec;36(4):301–308. doi: 10.1016/0020-7292(91)90484-m. [DOI] [PubMed] [Google Scholar]
  11. Houlston R., Bourne T. H., Davies A., Whitehead M. I., Campbell S., Collins W. P., Slack J. Use of family history in a screening clinic for familial ovarian cancer. Gynecol Oncol. 1992 Nov;47(2):247–252. doi: 10.1016/0090-8258(92)90114-x. [DOI] [PubMed] [Google Scholar]
  12. Kawai M., Kano T., Kikkawa F., Maeda O., Oguchi H., Tomoda Y. Transvaginal Doppler ultrasound with color flow imaging in the diagnosis of ovarian cancer. Obstet Gynecol. 1992 Feb;79(2):163–167. [PubMed] [Google Scholar]
  13. Kurjak A., Zalud I., Alfirevic Z. Evaluation of adnexal masses with transvaginal color ultrasound. J Ultrasound Med. 1991 Jun;10(6):295–297. doi: 10.7863/jum.1991.10.6.295. [DOI] [PubMed] [Google Scholar]
  14. Lynch H. T., Watson P., Bewtra C., Conway T. A., Hippee C. R., Kaur P., Lynch J. F., Ponder B. A. Hereditary ovarian cancer. Heterogeneity in age at diagnosis. Cancer. 1991 Mar 1;67(5):1460–1466. doi: 10.1002/1097-0142(19910301)67:5<1460::aid-cncr2820670534>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  15. Rottem S., Levit N., Thaler I., Yoffe N., Bronshtein M., Manor D., Brandes J. M. Classification of ovarian lesions by high-frequency transvaginal sonography. J Clin Ultrasound. 1990 May;18(4):359–363. doi: 10.1002/jcu.1870180422. [DOI] [PubMed] [Google Scholar]
  16. Sassone A. M., Timor-Tritsch I. E., Artner A., Westhoff C., Warren W. B. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol. 1991 Jul;78(1):70–76. [PubMed] [Google Scholar]
  17. Shepherd J. H. Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol. 1989 Aug;96(8):889–892. doi: 10.1111/j.1471-0528.1989.tb03341.x. [DOI] [PubMed] [Google Scholar]
  18. Van Nagell J. R., Jr, DePriest P. D., Puls L. E., Donaldson E. S., Gallion H. H., Pavlik E. J., Powell D. E., Kryscio R. J. Ovarian cancer screening in asymptomatic postmenopausal women by transvaginal sonography. Cancer. 1991 Aug 1;68(3):458–462. doi: 10.1002/1097-0142(19910801)68:3<458::aid-cncr2820680303>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  19. Weiner Z., Thaler I., Beck D., Rottem S., Deutsch M., Brandes J. M. Differentiating malignant from benign ovarian tumors with transvaginal color flow imaging. Obstet Gynecol. 1992 Feb;79(2):159–162. [PubMed] [Google Scholar]
  20. Young R. C., Walton L. A., Ellenberg S. S., Homesley H. D., Wilbanks G. D., Decker D. G., Miller A., Park R., Major F., Jr Adjuvant therapy in stage I and stage II epithelial ovarian cancer. Results of two prospective randomized trials. N Engl J Med. 1990 Apr 12;322(15):1021–1027. doi: 10.1056/NEJM199004123221501. [DOI] [PubMed] [Google Scholar]
  21. van Nagell J. R., Jr, Higgins R. V., Donaldson E. S., Gallion H. H., Powell D. E., Pavlik E. J., Woods C. H., Thompson E. A. Transvaginal sonography as a screening method for ovarian cancer. A report of the first 1000 cases screened. Cancer. 1990 Feb 1;65(3):573–577. doi: 10.1002/1097-0142(19900201)65:3<573::aid-cncr2820650331>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]

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