How to decrease false-positive cases of ovarian cancer screening by transvaginal sonography

Screening for ovarian cancer is an important step in improving ovarian cancer mortality. This is a report of screening for ovarian cancer using transvaginal sonography (TVS) on 2,095 asymptomatic women during the past four years. Ovarian tumors over 30 mm in diameter were detected in 87 women (4.2%). Fourteen tumors were morphologically classified as complex type and 73 as cystic type. Only 12 tumors were palpable on bimanual vaginal examination. Seven women with complex type tumors underwent laparotomy and their pathological diagnoses revealed 3 dermoid cysts, 3 endometrioid cysts and 1 ovarian cancer. Two women with cystic type tumors underwent laparotomy and their pathological diagnoses revealed 1 paraovarian cyst and 1 endometrioid cyst. Many ovarian tumors were detected at prolonged cycle of menstruation and 69% of them disappeared in repeated TVS. Sixty percent of ovarian cystic tumors under 50 mm in diameter also disappeared in repeated TVS. Close attention to menstrual cycle and morphologic findings is needed to decrease false-positive cases in TVS screening for ovarian cancer.