Screening for Ovarian Cancer

  • S. Campbell
  • T. Bourne
Part of the AGO Arbeitsgemeinschaft für Gynäkologische Onkologie book series (AGO)


As a profession we devote a huge amount of time and money to the early detection and investigation of cervical and endometrial carcinoma. If one considers the fact that more women die each year from ovarian cancer than from cancer of the uterus and cervix combined, the failure to investigate methods to detect ovarian cancer at an early stage is puzzling. The relative lack of information regarding the natural history of ovarian cancer has hindered workers in this field. The result is that the vital question of whether screening for and thus early detection and treatment of ovarian cancer actually reduces mortality from the disease has yet to be answered. A randomised controlled clinical trial is needed to test this hypothesis. We believe that an ultrasound based screening test now exists with sufficient sensitivity and specificity to be utilised in the context of such a clinical trial. This article will set out the arguments for this proposal.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Office of Population Censuses and Surveys: Cancer statistics: registrations, England and Wales 1984, HMSO. London, 1988Google Scholar
  2. 2.
    Day T.G., Smith J.P.: Diagnosis and staging of ovarian cancer. Semin. Oncol. 2: 217,1975PubMedGoogle Scholar
  3. 3.
    Young R.C., Walton L.A., Ellenberg S.S., Homesley H.D., Wilbanks G.D., Decker D.G., Miller A., Park R., Major F. Jr.: Adjuvant therapy in stage I and stage II epithelial ovarian cancers - results of two prospective randomised trials. N. Eng. J. Med. 322: 1021–1027,1990CrossRefGoogle Scholar
  4. 4.
    Annual report on cancer statisticsGoogle Scholar
  5. 5.
    Bourne T.H., Reynolds K., Campbell S.: Ovarian Cancer Screening. Eur. J. Cancer 27: 655–659,1991PubMedCrossRefGoogle Scholar
  6. 6.
    Wilson J.M.G., Jungner G.: In: Principles and Practice of Screening for Disease. Public Health Papers 34, World Health Organisation, Geneva, 1968Google Scholar
  7. 7.
    Cuckle H.S., Wald N.J., In Sharp F., Mason W., Leake R.E., eds.: Ovarian Cancer: Biological and Therapeutic Challenges. Cambridge, Chapman and Hall Medical, 229–239,1990Google Scholar
  8. 8.
    Daunter B.: Tumor markers in gynecologic oncology. Gynecol. Oncol. 39: 1–15,1990PubMedCrossRefGoogle Scholar
  9. 9.
    Jacobs I., Bast R.C.: The CA 125 tumour associated antigen: a review of the literature. Human Reproduction 4: 1–12,1989PubMedGoogle Scholar
  10. 10.
    Zurawski V.R., Orjaseter H., Anderson A., Jellum E.: Elevated serum CA 125 levels prior to the diagnosis of ovarian neoplasia: relevance for early detection of ovarian cancer. Int J. Cancer 42: 677–680,1988PubMedCrossRefGoogle Scholar
  11. 11.
    Jacobs I.J., Stabile I., Bridges J., Kemsley P., Reynolds C., Grudzinskas J.G., Oram D.H.: Multimodal approach to screening for ovarian cancer. Lancet, i: 268–271,1988Google Scholar
  12. 12.
    Zurawski V.R., Sjovall K., Schoenfeld D.A., Broderick S.F., Hall P., Bast R.C., Eklund G., Mattsson B., Connor R.J., Prorok P.C., Knapp R.C., Einhorn N.: Prospective evaluation of CA 125 levels in normal population, phase I: The specificities of single and serial determinations in testing for ovarian cancer. Gynecol. Oncol. 36: 299–305, 1990PubMedCrossRefGoogle Scholar
  13. 13.
    Campbell S., Goessons L., Goswamy R., Whitehead M.I.: Real time ultrasonography for determination of ovarian morphology and volume - a possible new screening test for ovarian cancer ? Lancet, i: 425–426, 1982Google Scholar
  14. 14.
    Campbell S., Bhan V., Royston P., Whitehead M.I., Collins W.P.:. Transabdominal ultrasound screening for early ovarian cancer. British. Medical Journal, 299: 1363–1367,1989PubMedCrossRefGoogle Scholar
  15. 15.
    Campbell S., Bhan V., Royston P., Whitehead M.I., Collins W.P.: Novel screening strategies for early ovarian cancer by transabdominal ultrasonography. Br. J. Obstet. Gynaecol. 97: 304–311, 1990PubMedCrossRefGoogle Scholar
  16. 16.
    Luxman D., Bergman A., Sagi J., David M.P.: The Postmenopausal Adnexal Mass: Correlation Between Ultrasonic and Pathologic Findings. Obstet. Gynecol. 77: 726–728, 1991PubMedGoogle Scholar
  17. 17.
    Parker W.H., Berek J.S.: Management of selected cystic adnexal masses in postmenopausal women by operative laparoscopy: a pilot study. Am. J. Obstet. Gynecol. 163: 1574–1577, 1990PubMedGoogle Scholar
  18. 18.
    Timor-Trisch I.E., Bar-Yam Y., Elgali S., Rottem S.: The technique of transvaginal sonography with the use of a 6.5 Mhz probe. Am. J. Obstet. Gynecol. 158: 1019–1024, 1988Google Scholar
  19. 19.
    Bourne T.H.: Transvaginal color Doppler in Gynecology. Ultrasound Obstets Gynecol.l: 359–373,1991CrossRefGoogle Scholar
  20. 20.
    Rodriguez M.H., Platt L.D., Medearis A.L., Lacarra M., Lobo R.A.: The use of transvaginal sonography for evaluation of postmenopausal ovarian size and morphology. Am. J. Obstet. Gynecol. 159: 810–814, 1988PubMedGoogle Scholar
  21. 21.
    Van Nagell J.R., Higgins R.V., Donaldson E.S., Gallion H.H., Powell D.E., Pavlik E.J., Woods C.H.: Transvaginal sonography as a screening test for ovarian cancer. A report of the first 1000 cases screened. Cancer 65: 573–577,1990PubMedCrossRefGoogle Scholar
  22. 22.
    Bourne T.H., Whitehead M.I., Campbell S., Royston P., Bhan V., Collins W.P.: Ultrasound screening for familial ovarian cancer. Gynecologic Oncology, 43: 92–97, 1991PubMedCrossRefGoogle Scholar
  23. 23.
    Lynch H.T., Watson P., Bewtra C., Conway T.A., Hippee C.R., Kaur P., Lynch J.F., Ponder B.A.J.: Hereditary ovarian cancer. Cancer 67: 1460–1466, 1991PubMedCrossRefGoogle Scholar
  24. 24.
    Meire H.B., Farrant P., Guha T.: Distinction of benign from malignant ovarian cysts by ultrasound. Br. J. Obstet. Gynaecol. 85: 893–899, 1978PubMedCrossRefGoogle Scholar
  25. 25.
    Sassone A.M., Timor-Tritsch I.E., Artner A., Westhoff C., Warren W.B.: Transvaginal sonographic characterisation of ovarian disease: evaluation of a new scoring system to predict malignancy. Obstet. Gynecol. 78: 70–76, 1991PubMedGoogle Scholar
  26. 26.
    Folkman J., Watson J., Ingber D., Hanahan D.: Induction of angiogenesis during the transition from hyperplasia to neoplasia. Nature (London), 339: 58–61,1989PubMedCrossRefGoogle Scholar
  27. 27.
    Bourne T.H., Campbell S., Steer C.V., Whitehead M.I., Collins W.P.: Transvaginal colour flow imaging: a possible new screening test for ovarian cancer. British Medical Journal, 229: 1367–1370, 1989CrossRefGoogle Scholar
  28. 28.
    Kurjak A., Zalud I.: Early detection of ovarian cancer by transvaginal color Doppler.J. Ultrasound Med. 10: 57, 1991Google Scholar
  29. 29.
    Bourne T.H., Jurkovic D., Waterstone J., Campbell S., Collins W.P.: Intrafollicular blood flow during human ovulation. Ultrasound Obstet. Gynecol. 1: 63–69,1991Google Scholar
  30. 30.
    Campbell S., Bourne T.H., Reynolds K., Hampson J., Royston P., Whitehead M.I., Collins W.P.: Role of colour Doppler in and ultrasound based screening programme. In Sharp F., Mason W.P., Leake R.E. (Eds) Ovarian Cancer Biological and Therapeutic Challenges, Vol II (Cambridge: Chapman and Hall Medical)Google Scholar
  31. 31.
    Bourne T.H., Campbell S., Royston P., Whitehead M.I., Steer C.V., Collins W.P.: Detection of Endometrial Cancer by Transvaginal Ultrasonography with Color Row Imaging and Blood Row Analysis: A Preliminary Report. Gynecologic Oncology 40: 253–259, 1991PubMedCrossRefGoogle Scholar
  32. 32.
    Granberg S.: Bladder tumors, Ultrasound Obstet. Gynecol. 1:1991Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • S. Campbell
  • T. Bourne

There are no affiliations available

Personalised recommendations