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More Accurate Identification For Women at Risk of Ovarian Cancer: Presented at SGO

By Norra MacReady

PALM SPRINGS, C.A. -- March 27, 2006 -- Clinicians can now identify with greater accuracy the women most likely to have ovarian cancer, thanks to new data from the Prostate, Lung, Colon and Ovarian (PLCO) Cancer Screening Trial presented here at the 37^th Annual Meeting of the Society of Gynecologic Oncologists (SGO).

The information will help many women avoid unnecessary surgeries, the researchers said during their presentation on March 23^rd.

The data were obtained from more than 28,000 asymptomatic postmenopausal women who underwent both transvaginal ultrasound (TVU) and cancer antigen 125 (CA 125) screening tests.

"Our major clinical objective was to establish useful criteria to assess the likelihood of finding a malignancy following an abnormal screen," said principal investigator Edward E. Partridge, MD, associate director, Cancer Prevention and Control, and professor of obstetrics and gynecology, University of Alabama, Birmingham, Alabama, United States.

During the initial phase of the trial (T₀), 28,816 women received at least one of the ovarian screening tests, and 28,506 women received both.

The baseline TVU was abnormal in 1338 women (4.7%), and the CA 125 was abnormal in 403 women (1.4%). Of women who received both tests, 34 (0.1%) had abnormalities in both. The investigators considered a CA 125 >/=65 U/mL or an ovary or cyst volume >10 cm³ to be abnormal.

Based on these abnormal findings, 570 women underwent surgery. Invasive cancers were detected in 3.5%. All of the participants underwent subsequent screening at years T₁, T₂, and T₃.

At the follow-up screenings, 1549 additional women had abnormal results on one or both tests. Of those, 321 underwent surgical evaluation, with 29 additional invasive cancers being detected.

The probability of detecting cancer based on an abnormal screening test was 1.2% at baseline and 1.9% following one of the subsequent screens.

Dr. Partridge said the best criteria for predicting malignancy were determined to be the following:
* CA 125 >65 U/mL;
* an increase in CA 125 of at least 40 points;
* an increase of 10 points with an ovary or cyst of at least 3 cm in diameter; or
* a change in ovarian or cyst diameter of 6.5 cm or more.

Women who do not meet these criteria can be reassured that they do not need surgery, Dr. Partridge noted.

He added, however, that the data shed no new light on the impact that screening has on ovarian-cancer mortality, and that it is therefore still too early to recommend routine performance of either test.

The PLCO Cancer Screening Trial is following healthy 55 to 74 year-olds to determine whether screening tests can reduce mortality from prostate, lung, colon and ovarian cancers.


[Presentation title: Determining the Risk of Ovarian Malignancy in Postmenopausal Women with Abnormal Findings in the PLCO Screening Trial: A Guide for Physicians. Abstract 21]

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