title: Screening for ovarian cancer in women with varying levels of risk, using annual tests, results in high recall for repeat screening tests.
abstract: BACKGROUND
  We assessed ovarian cancer screening outcomes in women with a positive family history of ovarian cancer divided into a low-, moderate- or high-risk group for development of ovarian cancer.
  
  
  METHODS
  545 women with a positive family history of ovarian cancer referred to the Ovarian Screening Service at the Royal Marsden Hospital, London from January 2000- December 2008 were included. They were stratified into three risk-groups according to family history (high-, moderate- and low-risk) of developing ovarian cancer and offered annual serum CA 125 and transvaginal ultrasound screening. The high-risk group was offered genetic testing.
  
  
  RESULTS
  The median age at entry was 44 years. The number of women in the high, moderate and low-risk groups was 397, 112, and 36, respectively. During 2266 women years of follow-up two ovarian cancer cases were found: one advanced stage at her fourth annual screening, and one early stage at prophylactic bilateral salpingo-oophorectomy (BSO). Prophylactic BSO was performed in 138 women (25.3%). Forty-three women had an abnormal CA125, resulting in 59 repeat tests. The re-call rate in the high, moderate and low-risk group was 14%, 3% and 6%. Equivocal transvaginal ultrasound results required 108 recalls in 71 women. The re-call rate in the high, moderate, and low-risk group was 25%, 6% and 17%.
  
  
  CONCLUSIONS
  No early stage ovarian cancer was picked up at annual screening and a significant number of re-calls for repeat screening tests was identified.
authors: Department of Gynaecological Oncology, The Institute of Cancer Research & The Royal Marsden Foundation Trust, Cotswold Road and Fulham Road, SW3 6JJ, London, UK. marielle.nobbenhuis@rmh.nhs.uk.
authors: Marielle Ae
authors: MA
authors: Nobbenhuis
authors: Elizabeth
authors: E
authors: Bancroft
authors: Eleanor
authors: E
authors: Moskovic
authors: Fiona
authors: F
authors: Lennard
authors: Paul
authors: P
authors: Pharoah
authors: Ian
authors: I
authors: Jacobs
authors: Ann
authors: A
authors: Ward
authors: Desmond Pj
authors: DP
authors: Barton
authors: Thomas Ej
authors: TE
authors: Ind
authors: John H
authors: JH
authors: Shepherd
authors: Jane E
authors: JE
authors: Bridges
authors: Martin
authors: M
authors: Gore
authors: Chris
authors: C
authors: Haracopos
authors: Susan
authors: S
authors: Shanley
authors: Audrey
authors: A
authors: Ardern-Jones
authors: Sarah
authors: S
authors: Thomas
authors: Ros
authors: R
authors: Eeles