Ultrasound examination for detection of ovarian carcinoma in risk groups

Ovarian ultrasound scanning was carried out as an adjunct to pelvic examination in 801 women between 40-70 years of age presenting at the outpatient Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden for a variety of gynecologic complaints. All belonged to a high-risk category for ovarian carcinoma because of nulliparity; family history of ovarian, breast, or endometrial carcinoma; previous cancer; or unspecified abdominal complaints. Of 638 patients with normal scans, findings at pelvic examination had been abnormal in 51 cases, and all were normal at subsequent clinical follow-up. Among 163 patients with abnormal ultrasound scans, one case of borderline ovarian tumor and two cases of endometrial cancer were found for which the pelvic examination had been considered normal. Clinical symptoms probably would have led to detection within a short time in these cases anyway, even if ultrasound had not been performed. Based on the findings in this study and the previous experience with gynecologic ultrasound in several thousand patients, it would not seem that ultrasound has a role in screening for ovarian carcinoma.