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Screening for ovarian cancer in women with varying levels of risk, using annual tests, results in high recall for repeat screening tests.

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Nobbenhuis, Marielle Ae 
Bancroft, Elizabeth 
Moskovic, Eleanor 
Lennard, Fiona 


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%. CONCLUSION: No early stage ovarian cancer was picked up at annual screening and a significant number of re-calls for repeat screening tests was identified.



ovarian cancer, screening, transvaginal ultrasound, serum CA125, BRCA gene mutation, bilateral salpingo-oophorectomy, BRCA1/2 MUTATION CARRIERS, SALPINGO-OOPHORECTOMY, FAMILY-HISTORY, BREAST, SURVEILLANCE, ULTRASOUND, SURGERY

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Hered Cancer Clin Pract

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Springer Science and Business Media LLC