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

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

Research output: Contribution to journalArticlepeer-review

98 Scopus citations

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.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalJournal of Clinical Oncology
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this