A multidisciplinary approach to the early detection of ovarian carcinoma: rationale, protocol design, and early results.
OBJECTIVE
This study was undertaken to determine the feasibility of currently available tests to detect ovarian cancer at a curable stage. By studying women at risk for the disease on the basis of their family histories of cancer, we hope to gain insight into the genetics and biologic characteristics of ovarian cancer.


METHODS
Asymptomatic women with a family history of cancer are interviewed by geneticists to obtain accurate pedigree and epidemiologic data. Screening tests including transvaginal ultrasonography, color Doppler imaging, CA 125 measurement, and other investigative biomarkers are performed between cycle days 3 and 8 and repeated biannually.


RESULTS
A total of 597 women without symptoms were screened between July 1991 and June 1992. Cystic or complex adnexal masses were detected in 6.2% of patients. A pulsatile index value < 1.0 was measured in 80% of premenopausal patients and 24% of postmenopausal patients, whereas a resistance index value < 0.4 occurred in 12% of premenopausal and 3% of postmenopausal patients. A CA 125 level > 35 U/ml was found in 11.4% of the study participants. To date, one stage IA borderline ovarian tumor and one endometrial carcinoma have been found.


CONCLUSIONS
Ovarian cancer screening needs to be investigated in a controlled fashion to determine means that will ultimately improve the survival from the disease.
Cedars-Sinai Medical Center/UCLA, Department of Obstetrics and Gynecology 90048.
B Y
BY
Karlan
L J
LJ
Raffel
G
G
Crvenkovic
C
C
Smrt
M D
MD
Chen
E
E
Lopez
C A
CA
Walla
C
C
Garber
P
P
Cane
D A
DA
Sarti
D000328:Adult; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D016889:Endometrial Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D005820:Genetic Testing; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging; D012212:Rheology; D012307:Risk Factors; D014465:Ultrasonics; D014463:Ultrasonography
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor