A MULTIDISCIPLINARY APPROACH TO THE EARLY DETECTION OF OVARIAN-CARCINOMA - RATIONALE, PROTOCOL DESIGN, AND EARLY RESULTS

OBJECTIVE: This study was undertaken to determine the feasibility of c urrently available tests to detect ovarian cancer at a curable stage. By studying women at risk for the disease on the basis of their family histories of cancer, we hope to gain insight into the genetics and bi ologic characteristics of ovarian cancer, STUDY DESIGN: Asymptomatic w omen with a family history of cancer are interviewed by geneticists to obtain accurate pedigree and epidemiologic data. Screening tests incl uding transvaginal ultrasonography, color Doppler imaging, CA 125 meas urement, and other investigative biomarkers are performed between cycl e days 3 and 8 and repeated biannually. RESULTS: A total of 597 women without symptoms were screened between July 1991 and June 1992. Cystic or complex adnexal masses were detected in 6.2% of patients. A pulsat ile index value < 1.0 was measured in 80% of premenopausal patients an d 24% of postmenopausal patients, whereas a resistance index value < 0 .4 occurred in 12% of premenopausal and 3% of postmenopausal patients. A CA 125 level > 35 U/ml was found in 11.4% of the study participants . To date, one stage IA borderline ovarian tumor and one endometrial c arcinoma have been found. CONCLUSIONS: Ovarian cancer screening needs to be investigated in a controlled fashion to determine means that wil l ultimately improve the survival from the disease.