Cancer screening in a high risk population: a clinical trial

The purpose of this paper is to report the results of screening high risk women for ovarian cancer using endovaginal ultrasound (EVUS), color flow Doppler and cancer antigen (CA) 125. A total of 252 women were recruited with a family history of ovarian cancer in at least 1 first-degree relative. All women underwent a pelvic examination and EVUS twice during the first year and annually thereafter. Of 210 premenopausal women in the study, 14 underwent surgery. Of these, 2 were based on the endovaginal ultrasound (US) results and proved to be false-positive. There were 48 postmenopausal women who underwent 9 operations. Of these, 2 were stimulated by finding a thickened stripe on EVUS, and proved to be endometrial carcinomas. There were 2 ovarian cancers, both advanced, 1 colon cancer and 1 renal cell cancer. Of the women, 6 had a history of breast cancer and 11 more developed it during the study. This high-risk population has a very high prevalence of breast cancer, and mammography must be a part of ovarian cancer screening programs.