PURPOSE: Our aim was to analyze the clinicopathologic features of screen-detected ovarian cancers identified in women, either at general population risk or high genetic risk of ovarian cancer, who have participated in screening studies. METHODS: Studies published between 1988 and April 2003 were categorized by the population screened and the primary screening modalities used. Each report was examined with reference to the histologic type, stage, and grade of screen-detected cancers. Reports of studies of prophylactically removed ovaries from women at high risk of ovarian cancer were also reviewed. RESULTS: Of the stage I tumors detected by screening women at population risk, almost half were borderline ovarian tumors, granulosa-cell tumors, or germ-cell tumors, which is disproportionate to their frequency. Furthermore, of the stage I invasive epithelial cancers diagnosed in women at population risk, the majority were endometrioid, clear-cell, and mucinous histologic subtypes. Most ovarian cancers that occur in women at high genetic risk are high-grade serous cancers, and these are infrequently screen detected at an early stage. CONCLUSION: The clinicopathologic features of screen-detected ovarian cancers suggest that screening may not reduce mortality in women at increased genetic risk. Prospective screening studies are required in genetically high-risk populations to answer this important question. Women electing surveillance should be aware of the lack of proven benefit and the low likelihood of detecting early stage serous cancers. Bilateral salpingo-oophorectomy appears to be the most effective approach to decrease the risk of ovarian cancer and thereby reduce mortality in high-risk women.
PURPOSE: Our aim was to analyze the clinicopathologic features of screen-detected ovarian cancers identified in women, either at general population risk or high genetic risk of ovarian cancer, who have participated in screening studies. METHODS: Studies published between 1988 and April 2003 were categorized by the population screened and the primary screening modalities used. Each report was examined with reference to the histologic type, stage, and grade of screen-detected cancers. Reports of studies of prophylactically removed ovaries from women at high risk of ovarian cancer were also reviewed. RESULTS: Of the stage I tumors detected by screening women at population risk, almost half were borderline ovarian tumors, granulosa-cell tumors, or germ-cell tumors, which is disproportionate to their frequency. Furthermore, of the stage I invasive epithelial cancers diagnosed in women at population risk, the majority were endometrioid, clear-cell, and mucinous histologic subtypes. Most ovarian cancers that occur in women at high genetic risk are high-grade serous cancers, and these are infrequently screen detected at an early stage. CONCLUSION: The clinicopathologic features of screen-detected ovarian cancers suggest that screening may not reduce mortality in women at increased genetic risk. Prospective screening studies are required in genetically high-risk populations to answer this important question. Women electing surveillance should be aware of the lack of proven benefit and the low likelihood of detecting early stage serous cancers. Bilateral salpingo-oophorectomy appears to be the most effective approach to decrease the risk of ovarian cancer and thereby reduce mortality in high-risk women.
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Authors: Steven J Skates; Mark H Greene; Saundra S Buys; Phuong L Mai; Powel Brown; Marion Piedmonte; Gustavo Rodriguez; John O Schorge; Mark Sherman; Mary B Daly; Thomas Rutherford; Wendy R Brewster; David M O'Malley; Edward Partridge; John Boggess; Charles W Drescher; Claudine Isaacs; Andrew Berchuck; Susan Domchek; Susan A Davidson; Robert Edwards; Steven A Elg; Katie Wakeley; Kelly-Anne Phillips; Deborah Armstrong; Ira Horowitz; Carol J Fabian; Joan Walker; Patrick M Sluss; William Welch; Lori Minasian; Nora K Horick; Carol H Kasten; Susan Nayfield; David Alberts; Dianne M Finkelstein; Karen H Lu Journal: Clin Cancer Res Date: 2017-01-31 Impact factor: 12.531
Authors: Carolyn Y Fang; Carol Cherry; Karthik Devarajan; Tianyu Li; John Malick; Mary B Daly Journal: Gynecol Oncol Date: 2009-01-13 Impact factor: 5.482
Authors: Mark H Greene; Marion Piedmonte; Dave Alberts; Mitchell Gail; Martee Hensley; Zoe Miner; Phuong L Mai; Jennifer Loud; Gustavo Rodriguez; Jack Basil; John Boggess; Peter E Schwartz; Joseph L Kelley; Katie E Wakeley; Lori Minasian; Stephen Skates Journal: Cancer Epidemiol Biomarkers Prev Date: 2008-03 Impact factor: 4.254