EARLY DETECTION OF OVARIAN-CANCER - PRELIMINARY-RESULTS OF THE YALE EARLY DETECTION PROGRAM

Citation
Pe. Schwartz et al., EARLY DETECTION OF OVARIAN-CANCER - PRELIMINARY-RESULTS OF THE YALE EARLY DETECTION PROGRAM, The Yale journal of biology & medicine, 64(6), 1991, pp. 573-582
Citations number
10
Language
INGLESE
art.tipo
Article
ISSN journal
0044-0086
Volume
64
Issue
6
Year of publication
1991
Pages
573 - 582
Database
ISI
SICI code
0044-0086(1991)64:6<573:EDOO-P>2.0.ZU;2-W
Abstract
Eighty-four women at high risk for ovarian cancer by having first-degr ee relatives with epithelial ovarian cancer participated in a newly es tablished, early ovarian cancer detection program at Yale University. Participants were to be evaluated with physical examinations and circu lating tumor markers at entry and every six months thereafter. Endovag inal ultrasound and color Doppler flow studies were to be performed at three and nine months following entry into the program. In addition, women were encouraged to follow American Cancer Society guidelines for mammography. Stool was checked for occult blood. Endometrial sampling was offered to post-menopausal women. No participant has developed an ovarian cancer since entering the program. One woman has been diagnos ed to have breast cancer. False-positive levels of circulating tumor m arkers (CA 125, 4/84 [4.8 percent]; lipid-associated sialic acid in pl asma, 13/84 [15.5 percent]; NB/70K, 4/84 [4.8 percent]; and urinary go nadotropin fragment, 1/65 [1.5 percent]) were observed on entry into t he program. Low resistive indices (< 0.5) were documented in 8/91 (8.8 percent) ovaries studied by the color Doppler flow technique. One par ticipant underwent a laparotomy based on a false-positive endovaginal ultrasound examination. Tests now being employed in community practice have a high likelihood of being associated with false-positive result s. Therapeutic interventions based on isolated abnormal tumor markers or ultrasound studies obtained from women with family histories of ova rian cancer may lead to inappropriate surgery. It is necessary for can cer centers to develop expertise in ovarian cancer detection technique s to advise physicians in their geographic areas appropriately about t he significance of the abnormal screening test.