title: Screening for ovarian cancer: the preliminary experience of a familial ovarian cancer center.
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 > or = 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.
authors.affiliation: Division of Gynecologyic Oncology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: M G
authors.initials: MG
authors.lastname: Muto
authors.forename: D W
authors.initials: DW
authors.lastname: Cramer
authors.forename: D L
authors.initials: DL
authors.lastname: Brown
authors.forename: W R
authors.initials: WR
authors.lastname: Welch
authors.forename: B L
authors.initials: BL
authors.lastname: Harlow
authors.forename: H
authors.initials: H
authors.lastname: Xu
authors.forename: J P
authors.initials: JP
authors.lastname: Brucks
authors.forename: S W
authors.initials: SW
authors.lastname: Tsao
authors.forename: R S
authors.initials: RS
authors.lastname: Berkowitz
mesh_terms: D000328:Adult; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods; D008597:Menstrual Cycle / Q000276:immunology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000517:prevention & control*; D011237:Predictive Value of Tests; D014463:Ultrasonography / Q000379:methods; D014621:Vagina
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate