title: Gynecological surveillance in high risk women.
abstract: In high-risk women, risk reducing surgery remains the cornerstone of prevention. However, the resulting premature menopause has led to continued efforts to develop effective screening strategies for those who wish to delay or avoid surgery. This review describes how the screening of women at risk of ovarian and endometrial cancer has evolved to its current state. Serial monitoring of CA125 is core to ovarian cancer screening and most recent studies have used the Risk of Ovarian Cancer Algorithm (ROCA) to interpret CA125 profile. The additional use of a second tumour marker, HE4, is reviewed. The results to date of key ovarian cancer screening studies in high-risk women are summarised ahead of their concluding findings due later in 2016. The role of both ultrasound and endometrial sampling in the management of women at increased risk of endometrial cancer is outlined. Exciting new methodology, which could help shape the future of screening is investigated. The article summarises the current recommendations and guidelines from recognised international bodies to aid the clinician with management of these women.
authors.affiliation: Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, London, UK - u.menon@ucl.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: Dilley
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Gentry-Maharaj
authors.forename: Usha
authors.initials: U
authors.lastname: Menon
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000032:analysis; D018394:CA-125 Antigen / Q000032:analysis*; D055088:Early Detection of Cancer / Q000379:methods; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen