title: Evidence of Stage Shift in Women Diagnosed With Ovarian Cancer During Phase II of the United Kingdom Familial Ovarian Cancer Screening Study.
abstract: Purpose To establish the performance of screening with serum cancer antigen 125 (CA-125), interpreted using the risk of ovarian cancer algorithm (ROCA), and transvaginal sonography (TVS) for women at high risk of ovarian cancer (OC) or fallopian tube cancer (FTC). Patients and Methods Women whose estimated lifetime risk of OC/FTC was ≥ 10% were recruited at 42 centers in the United Kingdom and underwent ROCA screening every 4 months. TVS occurred annually if ROCA results were normal or within 2 months of an abnormal ROCA result. Risk-reducing salpingo-oophorectomy (RRSO) was encouraged throughout the study. Participants were observed via cancer registries, questionnaires, and notification by centers. Performance was calculated after censoring 365 days after prior screen, with modeling of occult cancers detected at RRSO. Results Between June 14, 2007, and May 15, 2012, 4,348 women underwent 13,728 women-years of screening. The median follow-up time was 4.8 years. Nineteen patients were diagnosed with invasive OC/FTC within 1 year of prior screening (13 diagnoses were screen-detected and six were occult at RRSO). No symptomatic interval cancers occurred. Ten (52.6%) of the total 19 diagnoses were stage I to II OC/FTC (CI, 28.9% to 75.6%). Of the 13 screen-detected cancers, five (38.5%) were stage I to II (CI, 13.9% to 68.4%). Of the six occult cancers, five (83.3%) were stage I to II (CI, 35.9% to 99.6%). Modeled sensitivity, positive predictive value, and negative predictive value for OC/FTC detection within 1 year were 94.7% (CI, 74.0% to 99.9%), 10.8% (6.5% to 16.5%), and 100% (CI, 100% to 100%), respectively. Seven (36.8%) of the 19 cancers diagnosed < 1 year after prior screen were stage IIIb to IV (CI, 16.3% to 61.6%) compared with 17 (94.4%) of 18 cancers diagnosed > 1 year after screening ended (CI, 72.7% to 99.9%; P < .001). Eighteen (94.8%) of 19 cancers diagnosed < 1 year after prior screen had zero residual disease (with lower surgical complexity, P = .16) (CI, 74.0% to 99.9%) compared with 13 (72.2%) of 18 cancers subsequently diagnosed (CI, 46.5% to 90.3%; P = .09). Conclusion ROCA-based screening is an option for women at high risk of OC/FTC who defer or decline RRSO, given its high sensitivity and significant stage shift. However, it remains unknown whether this strategy would improve survival in screened high-risk women.
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Adam N
authors.initials: AN
authors.lastname: Rosenthal
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Lindsay S M
authors.initials: LSM
authors.lastname: Fraser
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Philpott
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Manchanda
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Burnell
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Badman
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Hadwin
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Rizzuto
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Benjamin
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Naveena
authors.initials: N
authors.lastname: Singh
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: D Gareth
authors.initials: DG
authors.lastname: Evans
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Eccles
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Andy
authors.initials: A
authors.lastname: Ryan
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Liston
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Dawnay
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Ford
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Gunu
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Mackay
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Skates
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Usha
authors.initials: U
authors.lastname: Menon
authors.affiliation: Adam N. Rosenthal, Lindsay S.M. Fraser, Susan Philpott, Ranjit Manchanda, Matthew Burnell, Philip Badman, Richard Hadwin, Ivana Rizzuto, Andy Ryan, Robert Liston, Jeremy Ford, Richard Gunu, Usha Menon, and Ian J. Jacobs, University College London Elizabeth Garrett Anderson Institute for Women's Health; Elizabeth Benjamin, University College London; Naveena Singh, Barts Health National Health Service Trust; Ranjit Manchanda, Barts Cancer Institute, Queen Mary University of London; Anne Dawnay, University College London Hospital; James Mackay, The University College London Cancer Institute, London; D. Gareth Evans, University of Manchester, St Mary's Hospital Manchester, Manchester; Diana M. Eccles, Southampton General Hospital, Southampton, United Kingdom; Steven J. Skates, Massachusetts General Hospital and Harvard Medical School, Boston, MA; and Ian J. Jacobs, University of New South Wales Australia, Sydney, New South Wales, Australia.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018394:CA-125 Antigen / Q000097:blood; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods; D005185:Fallopian Tube Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods; D006113:United Kingdom
chemical_list: D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins