Urinary hCG Screening in the Gynecologic Oncology Population

Abstract

Objective: Human chorionic gonadotropin (hCG) testing is well established as a diagnostic tool for gestational trophoblastic disease (GTD) but it may also be produced by other gynecologic malignancies. The primary goal of this study was to evaluate whether urinary hCG screening using a highly sensitive testing system might identify gynecologic and nongynecologic malignancies that produce hCG. Design: This study was conducted as a retrospective chart review. Methods: The records of 1003 consecutive patients who presented to the Yale University Gynecologic Oncology Clinic were retrospectively reviewed and clinical and histologic data were extracted. All of these women routinely underwent urinary hCG testing. Results: Forty-one percent of all patients diagnosed with a gynecologic malignancy were found to have uterine cancer, and 38% of all patients had ovarian cancer. Less than 15% of patients were diagnosed with cervical, fallopian tube, primary peritoneal, vulvar, or vaginal carcinoma. A total of 8 patients had a positive urine pregnancy test. Six of these patients were known to be pregnant. One patient was referred with a complete hydatidiform mole. One patient was diagnosed with stage IIC clear cell ovarian carcinoma. Conclusions: Less than 0.1% of the nonpregnant patients without gestational trophoblastic disease had a positive urine pregnancy test. Based on the results of this study, urinary hCG screening can not be recommended to screen for malignancies that produce hCG. J GYNECOL SURG 27:143)