[Program for early detection of ovarian cancer for women as prophylaxis provided at a municipal hospital].
Neoplasms are still severe social problem; they are one of the most common causes of death (30-40%), they last for a very long time and the symptoms are characterized by significant intensity. There have been many attempts of introducing an effective screening program for early detection of ovarian cancer. This paper describes one of them, taking place in municipal hospital. To create and introduce a complex prophylactic program considering early diagnosis of ovarian cancer (with use of Doppler transvaginal sonography and serologic markers--CA125); to assess the value of various features (TVS, CA125 levels, family history) for sensitivity and specificity of screening method; to assess the effectiveness of Doppler TVS as a screening method; and to describe the group of participants that is of the best benefit in screening program. From October 1997 to December 2000 the Program for Early Detection of Ovarian Cancer, introduced by Foundation "Godula HOPE", gathered 3775 women aged 46 +/- 9.5. Most of the participants were self-referred, but there was the group of doctor-referred patients. Bimanual pelvic examination and Doppler TVS were performed in all participants; in case of doubtful results of TVS--serum CA 125 was obtained. The form created by author was used to gather the most important information of medical and family history. The most of participating women were: above 45 yr. old, married, on middle education level, non-working or mental worker, living in town. 365 adnexal tumors were detected among examined women. Using our own criteria 228 patients were chosen to laparotomy--16 of operated tumors were histologically confirmed to be malignant. Our sensitivity of PI was 93.75%, specificity--89.62%. The values for RI were respectively: 89.61% and 73.72%. Program of early detection of ovarian cancer using transvaginal sonography can be organized in municipal hospital; the most important feature of the examination (for screening program) is the grayscale sonographic morphology and the Doppler parameters are of additional value. The best cut-off values of PI and RI were 0.8 and 0.5 respectively. The great meaning of family history of ovarian cancer was confirmed. Demographic results suggest that program should be modified to be available for older patients on low level of education with family history of ovarian or breast cancer.
Cnota
Wojciech
W
Z Oddziału Klinicznego Połoznictwa i Ginekologii w Rudzie Slaskiej.
Sodowski
Krzysztof
K
Olesiak-Andryszczak
Małgorzata
M
Pilch-Kowalczyk
Marek
M
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006266:Health Education / Q000592:standards*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*; D011044:Poland / Q000453:epidemiology; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D016387:Women's Health
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen