BACKGROUND, International Federation of Gynecology and Obstetrics Stage I o
varian carcinoma, which has the worst prognosis among all types of gynecolo
gic carcinoma, has a high cure rate as has been reported, but early diagnos
is is difficult and to the authors' knowledge screening methods have not be
en established. Since 1989, the authors have performed transvaginal ultraso
nography (TVS) as a form of screening for ovarian carcinoma. The purpose of
the current study was to summarize and evaluate screening results for the
last 10 years with respect to ovarian carcinoma diagnosis and risk factors.
METHODS. Primary screening by TVS was performed in asymptomatic women who p
articipated in annual uterine cervical carcinoma screening. Four scanning s
ections by TVS were established and all sonograms were recorded. Women with
abnormal sonograms (a mass > 30 mm in greatest dimension or a mass with a
mixed pattern) received secondary screening and closer examination with a t
umor marker and an imaging diagnostic examination. Laparotomy was conducted
on all masses with a greatest dimension of greater than or equal to 60 mm
or on suspected malignant masses. Subject information-related risk factors
also were recorded.
RESULTS. Subjects were 183,034 women who participated in primary screening.
Of these women, 51,550 were undergoing screening for the first time. The t
ime required for primary screening was 1 minute per subject. Secondary scre
ening was required for 5309 participants (10.3%) and surgery was performed
on 324 participants. Twenty-two primary tumors and 2 metastatic tumors were
detected for a diagnostic rate of 0.047%. Of the 22 primary tumors, 17 (77
.3%) were classified as Stage I carcinoma, with tumor markers positive only
for 5 (29.4%). The percentage of the total number of Stage I ovarian carci
noma cases increased after the induction of screening from 29.7% to 58.8%.
CONCLUSIONS. These results are significant in that 77.3% of the primary ova
rian carcinomas found during the current screening were of curable Stage I.
Increased use of TVS screening for ovarian carcinoma may increase the chan
ce for early diagnosis and decrease the mortality of the disease. (C) 2000
American Cancer Society.