title: Results of annual screening in phase I of the United Kingdom familial ovarian cancer screening study highlight the need for strict adherence to screening schedule.
abstract: OBJECTIVE
  To establish the performance characteristics of annual transvaginal ultrasound and serum CA125 screening for women at high risk of ovarian/fallopian tube cancer (OC/FTC) and to investigate the impact of delayed screening interval and surgical intervention.
  
  
  METHODS
  Between May 6, 2002, and January 5, 2008, 3,563 women at an estimated ≥ 10% lifetime risk of OC/FTC were recruited and screened by 37 centers in the United Kingdom. Participants were observed prospectively by centers, questionnaire, and national cancer registries.
  
  
  RESULTS
  Sensitivity for detection of incident OC/FTC at 1 year after last annual screen was 81.3% (95% CI, 54.3% to 96.0%) if occult cancers were classified as false negatives and 87.5% (95% CI, 61.7% to 98.5%) if they were classified as true positives. Positive and negative predictive values of incident screening were 25.5% (95% CI, 14.3 to 40.0) and 99.9% (95% CI, 99.8 to 100) respectively. Four (30.8%) of 13 incident screen-detected OC/FTCs were stage I or II. Compared with women screened in the year before diagnosis, those not screened in the year before diagnosis were more likely to have ≥ stage IIIc disease (85.7% v 26.1%; P = .009). Screening interval was delayed by a median of 88 days before detection of incident OC/FTC. Median interval from detection screen to surgical intervention was 79 days in prevalent and incident OC/FTC.
  
  
  CONCLUSIONS
  These results in the high-risk population highlight the need for strict adherence to screening schedule. Screening more frequently than annually with prompt surgical intervention seems to offer a better chance of early-stage detection.
authors.affiliation: Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. a.rosenthal@qmul.ac.uk
authors.forename: Adam N
authors.initials: AN
authors.lastname: Rosenthal
authors.forename: Lindsay
authors.initials: L
authors.lastname: Fraser
authors.forename: Ranjit
authors.initials: R
authors.lastname: Manchanda
authors.forename: Philip
authors.initials: P
authors.lastname: Badman
authors.forename: Susan
authors.initials: S
authors.lastname: Philpott
authors.forename: Jessica
authors.initials: J
authors.lastname: Mozersky
authors.forename: Richard
authors.initials: R
authors.lastname: Hadwin
authors.forename: Fay H
authors.initials: FH
authors.lastname: Cafferty
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Benjamin
authors.forename: Naveena
authors.initials: N
authors.lastname: Singh
authors.forename: D Gareth
authors.initials: DG
authors.lastname: Evans
authors.forename: Diana M
authors.initials: DM
authors.lastname: Eccles
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Skates
authors.forename: James
authors.initials: J
authors.lastname: Mackay
authors.forename: Usha
authors.initials: U
authors.lastname: Menon
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D055088:Early Detection of Cancer / Q000592:standards*; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D019983:Guideline Adherence; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000235:genetics / Q000517:prevention & control; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000517:prevention & control; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000517:prevention & control; D011379:Prognosis; D011446:Prospective Studies; D006113:United Kingdom