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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.

Rosenthal, Adam N; Fraser, Lindsay; Manchanda, Ranjit; Badman, Philip; Philpott, Susan; Mozersky, Jessica; Hadwin, Richard; Cafferty, Fay H; Benjamin, Elizabeth; Singh, Naveena; Evans, D Gareth; Eccles, Diana M; Skates, Steven J; Mackay, James; Menon, Usha; Jacobs, Ian J

Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013;31(1):49-57.

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Abstract

PURPOSE: 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. PATIENTS AND 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. CONCLUSION: 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.

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Record metadata

Manchester eScholar ID:
uk-ac-man-scw:210738
Created by:
Evans, Gareth
Created:
12th October, 2013, 13:28:13
Last modified by:
Evans, Gareth
Last modified:
12th October, 2013, 13:28:13

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