Screening Tool For Ovarian Cancer Research Articles

Ultrahigh resolution lipid mass spectrometry imaging of high-grade serous ovarian cancer mouse models.

No effective screening tools for ovarian cancer (OC) exist, making it one of the deadliest cancers among women. Considering that little is known about the detailed progression and metastasis mechanism of OC at a molecular level, it is crucial to gain more insights into how metabolic and signaling alterations accompany its development. Herein, we present a comprehensive study using ultra-high-resolution Fourier transform ion cyclotron resonance matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) to investigate the spatial distribution and alterations of lipids in ovarian tissues collected from double knockout (n = 4) and triple mutant mouse models (n = 4) of high-grade serous ovarian cancer (HGSOC). Lipids belonging to a total of 15 different classes were annotated and their abundance changes were compared to those in healthy mouse reproductive tissue (n = 4), mapping onto major lipid pathways involved in OC progression. From intermediate-stage OC to advanced HGSC, we provide direct visualization of lipid distributions and their biological links to inflammatory response, cellular stress, cell proliferation, and other processes. We also show the ability to distinguish tumors at different stages from healthy tissues via a number of highly specific lipid biomarkers, providing targets for future panels that could be useful in diagnosis.

Cancer Screening Experiences of Black Breast and Ovarian Cancer Patients and Family Members.

Black women experience disproportionate rates of advanced breast cancer diagnoses and mortality. Mammography is a proven and effective tool in early breast cancer detection and impacts patient outcomes. We interviewed Black women with a personal or family history of breast and/or ovarian cancer to understand their screening experiences and views. N = 61 individuals completed an interview. Interview transcripts were qualitatively analyzed for themes regarding clinical experiences, guideline adherence, and family sharing specific to Black women and their families. Most participants were college educated with active health insurance. Women in this cohort were knowledgeable about the benefits of mammography and described few barriers to adhering to annual mammogram guidelines. Some with first-degree family history were frustrated at insurance barriers to mammography before the age of 40. Participants were generally comfortable encouraging family and friends to receive mammograms and expressed a desire for a similar screening tool for ovarian cancer. However, they expressed concern that factors such as screening awareness and education, lack of insurance coverage, and other systematic barriers might prevent other Black women from receiving regular screening. Black women in this cohort reported high adherence to mammography guidelines, but expressed concern about cultural and financial barriers that may impact cancer screening access in the population more generally and contribute to disparities. Participants noted the importance of frank and open discussions of breast cancer screening in their families and community as a means of improving awareness.

ANALYSIS OF SYMPTOMS IN OVARIAN CANCER AND ITS HISTOPATHOLOGICAL CORRELATION: A CROSS SECTIONAL STUDY

Ovarian cancer is the fth common cancer affecting the population and it is a silent killer, as it is diagnosed in later stages. The symptoms of ovarian cancer are nonspecic and a screening tool for ovarian cancer is not there. Diagnosis of ovarian cancer is often delayed due to their presentation with vague and nonspecic symptoms. This study tried to evaluate the symptoms in patients with ovarian cancer and correlate them with the type and stage of malignancy. Analyze the type, duration and frequency of the symptomsObjective: in patients with ovarian cancer and to correlate these symptoms with the type of malignancy and stage of the disease. All patientsMethods: admitted to the Gynaecology Department of Government Medical College, Thrissur with suspected ovarian cancer during the study period were recruited and surveyed using a baseline health questionnaire and a symptom index assessment form suggested by Goff et al was used (1). Assessment was then done to look for any correlation between the symptom duration, severity and frequency of symptoms and the type of ovarian malignancy. Fatigue followed by indigestion, increase in abdominal size, abdominal bloating, backache,Results and Discussion- feeling full quickly were the most common symptoms. A mean of 7.6 symptoms out of 23 symptoms enquired about in these women were present for a duration of 1 - 4 months. Abdominal bloating sensation was signicantly increased in patients more than 50yrs of age. A rise in CA125 value was also associated signicantly with fatigue and abdominal bloating sensation. Epithelial ovarian tumors were found to be signicantly associated with indigestion and feeling of fullness quickly. Non epithelial varieties were more often associated with menstrual irregularities and constipation. The symptom index can be used as a screening tool for ovarian cancer. Ignoring early warning symptoms will result inConclusion- late diagnosis of ovarian malignancy and thereby worsen the prognosis for such women.

Past, Present, and Future of Serum Tumor Markers in Management of Ovarian Cancer: A Guide for the Radiologist.

The ability to accurately detect early ovarian cancer and subsequently monitor treatment response is essential to improving survival for patients with ovarian malignancies. Several serum tumor markers (STMs)-including cancer antigen 125 (CA-125), human epididymis protein 4 (HE4), cancer antigen 19-9 (CA 19-9), and carcinoembryonic antigen (CEA)-have been used as a noninvasive method of identifying ovarian cancer in conjunction with imaging. Although current guidelines do not recommend use of STMs as screening tools for ovarian cancer, these markers have clinical utility in both diagnosis and surveillance for women with ovarian cancer. CA-125 is the most commonly used STM; its level may be elevated in several types of ovarian cancer, including epithelial cell tumors, carcinosarcoma, teratomas, and secondary ovarian malignancies. An elevated level of CA 19-9 is associated with clear cell tumors, teratomas, and secondary malignancies. CEA is most commonly associated with mucinous ovarian cancers. Finally, HE4 is being increasingly used to identify certain subtypes of epithelial ovarian cancers, particularly serous and endometrioid tumors. Diagnosis of ovarian cancers relies on a combination of CA-125 levels and US findings, which include a large adnexal mass or high-risk features, including septa and increased vascularity. CT is preferred for staging and is used along with PET and STM monitoring for surveillance. Increasingly, MRI is being used to characterize ovarian lesions that are indeterminate at US or CT. The future of STM testing involves development of "liquid biopsies," in which plasma samples are analyzed for evidence of tumors, including circulating tumor DNA or tumor cells and tumor micro-RNA. When combined with traditional imaging techniques, liquid biopsies may lead to earlier diagnosis and improved survival. An invited commentary by Shinagare is available online. ©RSNA, 2021.

Nano-scavengers for blood biomarker discovery in ovarian carcinoma

The development and implementation of biomarker-based screening tools for ovarian cancer require novel analytical platforms to enable the discovery of biomarker panels that will overcome the limitations associated with the clinically used CA-125.The systematic discovery of protein biomarkers directly from human plasma using proteomics remains extremely challenging, due to the wide concentration range of plasma proteins. Here, we describe the use of lipid-based nanoparticles (NPs) as an ‘omics’ enrichment tool to amplify cancer signals in the blood and to uncover disease specific signatures. We aimed to exploit the spontaneous interaction of clinically-used liposomes (Caelyx®) with plasma proteins, also known as’ protein corona’ formation, in order to facilitate the discovery of previously unreported differentially abundant molecules. Caelyx® liposomes were incubated with plasma samples obtained from advanced ovarian carcinoma patients and healthy donors and corona-coated liposomes were subsequently recovered. Comprehensive comparison between ‘healthy’ and ‘diseased’ corona samples by label-free proteomics resulted in the identification of multiple differentially abundant proteins. Moreover, immunoassay-based validation of selected proteins demonstrated the potential of nanoparticle-platform proposed to discover novel molecules with great diagnostic potential. This study proposes a nanoparticle-enabled workflow for plasma proteomic analysis in healthy and diseased states and paves the way for further work needed to discover and validate panels of novel biomarkers for disease diagnosis and monitoring.

Ovarian cancer: screening and future directions.

Ovarian cancer carries a lifetime risk of approximately 2% for women and is the leading cause of death from any gynecologic malignancy. Currently, no screening program for ovarian cancer exists for the general population in the UK. This review focuses on the evidence surrounding the efficacy of current markers and discusses future improvements in screening for this disease. One-off cancer antigen 125 (CA125) measurements for detecting ovarian cancer have been well researched. However, studies have highlighted low positive predictive values (5%) and high false positive rates leading to patient anxiety and unnecessary invasive follow-up. Commonly, in the UK, CA125 is combined with transvaginal ultrasound, but there is little evidence that this approach can decrease mortality from ovarian cancer. Recently the Risk of Ovarian Cancer Algorithm, involving a combination of serial CA125 measurements and age, has been shown to detect more early stage cancers. Nevertheless, these measures are not robust in decreasing mortality from ovarian cancer and are costly to implement. Newer markers, such as human epididymis protein 4, have shown greater specificity. Its combination with CA125 and menopausal status in the Risk of Ovarian Malignancy Algorithm can predict the risk of malignancy but provides no additional benefit as a screening tool. Advanced techniques are emerging, including ultrasound molecular imaging techniques using microbubbles targeted to kinase domain receptors, and fallopian tube cytology. To reduce mortality from ovarian cancer, detection of pre-invasive lesions is imperative as ovarian cancer may develop in the fallopian tube and spread to the peritoneal cavity before being detected systemically. It seems that screening tools for ovarian cancer are currently not worthwhile for implementation into a national program. An emphasis on reducing false positives rates, associated anxiety and subsequent overdiagnosis is needed.

Raman spectroscopic techniques to detect ovarian cancer biomarkers in blood plasma

Robust diagnosis of ovarian cancer is crucial to improve patient outcomes. The lack of a single and accurate diagnostic approach necessitates the advent of novel methods in the field. In the present study, two spectroscopic techniques, Raman and surface-enhanced Raman spectroscopy (SERS) using silver nanoparticles, have been employed to identify signatures linked to cancer in blood. Blood plasma samples were collected from 27 patients with ovarian cancer and 28 with benign gynecological conditions, the majority of which had a prolapse. Early ovarian cancer cases were also included in the cohort (n = 17). The derived information was processed to account for differences between cancerous and healthy individuals and a support vector machine (SVM) algorithm was applied for classification. A subgroup analysis using CA-125 levels was also conducted to rule out that the observed segregation was due to CA-125 differences between patients and controls. Both techniques provided satisfactory diagnostic accuracy for the detection of ovarian cancer, with spontaneous Raman achieving 94% sensitivity and 96% specificity and SERS 87% sensitivity and 89% specificity. For early ovarian cancer, Raman achieved sensitivity and specificity of 93% and 97%, respectively, while SERS had 80% sensitivity and 94% specificity. Five spectral biomarkers were detected by both techniques and could be utilised as a panel of markers indicating carcinogenesis. CA-125 levels did not seem to undermine the high classification accuracies. This minimally invasive test may provide an alternative diagnostic and screening tool for ovarian cancer that is superior to other established blood-based biomarkers.

Abstract B51: Dairy, calcium, vitamin D and ovarian cancer risk in African-American women

Abstract Background: Ovarian cancer is the leading cause of death from gynecologic cancers in the US. Currently there is no reliable screening available for ovarian cancer. Most cases are diagnosed at an advanced stage, with a poor survival rate. Therefore, a better understanding of the etiology and prevention is especially important for ovarian cancer. It has been hypothesized lactose in dairy may have a direct toxicity effect on oocytes, while the other two abundant nutrients from dairy foods, calcium and vitamin D, may have anti-tumorigenic properties. In addition to food and supplemental intakes, vitamin D in humans can also be achieved through skin synthesis upon sun exposure. However, darker skin color may reduce the penetration of ultraviolet-B, resulting in the lower cutaneous synthesis of vitamin D. This, together with the tendency of African Americans (AAs) to have lower consumption of vitamin D and calcium from dietary and supplemental sources, place AA women at risk for vitamin D and calcium deficiency. Objective: To evaluate intakes of dairy foods, lactose, calcium, and vitamin D exposure (through diet, supplement and sunlight) and the risk of ovarian cancer among AA women. Methods: We evaluated these associations among 490 ovarian cancer cases and 656 controls of AA descent recruited from the African American Cancer Epidemiology Study, a population-based case-control study in 11 geographical areas in the US. Cases were identified through rapid case ascertainment and age- and site-frequency matched controls were identified by random-digit-dialing. Information on risk factors related to ovarian cancer was collected by a computer-assisted telephone interview. Daily hours spent outdoors in daylight were asked separately on weekdays or weekends, and in summer or the rest of the year. Dietary information was assessed via a self-administered Block 2005 food frequency questionnaire (FFQ). Supplemental intake of calcium or vitamin D including multivitamin sources was also collected. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for relevant sociodemographic, reproductive, and lifestyle risk factors. Results: In the multivariable- and mutually-adjusted model, whole milk consumption was significantly associated with increased ovarian cancer risk (OR=1.85 comparing consumers with above-median intake vs. non-consumers, 95% CI: 1.05-3.27; p-trend: 0.023). No association was observed for skim/low-fat milk, cheese or yogurt. Lactose intake was found to increase ovarian cancer risk [OR=1.97 comparing the highest quartile (Q4) vs. lowest (Q1), 95% CI: 1.25-3.10; p-trend: 0.008]. Calcium intake was consistently associated with a decreased risk, with a similar OR for calcium from food, supplement, or total from both sources when comparing the highest to the lowest intake category. For example, total calcium intake was associated with a 49% decreased OR comparing Q4 vs. Q1 (95% CI: 0.30-0.86; p-trend: 0.009). Although we found no association with total and dietary vitamin D intakes, more daylight hours spent outdoors in summer months predicted a lower risk of ovarian cancer (OR=0.71 comparing Q4 vs. Q1, 95% CI: 0.51-0.99; p-trend: 0.049). Conclusion: Our findings suggest, for the first time, that sun exposure in summer months and a high-calcium, low-lactose diet may decrease the risk of ovarian cancer in AA women. Considering that there is no effective screening tool for ovarian cancer and the poorer survival of AA patients, if replicated in future studies these results open up potential preventive strategies through lifestyle or dietary modifications. Citation Format: Bo Qin, Patricia G. Moorman, Anthony J. Alberg, Jill S. Barnholtz-Sloan, Melissa Bondy, Michele L. Cote, Ellen Funkhouser, Edward S. Peters, Ann G. Schwartz, Paul Terry, Joellen M. Schildkraut, Elisa V. Bandera. Dairy, calcium, vitamin D and ovarian cancer risk in African-American women. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B51.

The Value of Ultrasound Monitoring of Adnexal Masses for Early Detection of Ovarian Cancer.

Although ultrasound has so far been found to be ineffective as a screening tool for ovarian cancer, it is commonly used as a means of evaluating or following ovarian or adnexal masses once they are detected. We review the use of serial ultrasound for the management of adnexal masses and propose an approach to monitoring based on an understanding of the overall risk of cancer among the population in question and an assessment of how the potential benefit of monitoring compares with potential risk. In our approach, masses that are symptomatic, large (>10 cm), associated with an elevated CA 125 level or overt signs of malignancy, or that are determined to have a worrisome appearance by stringent ultrasound criteria should be evaluated surgically. Women with masses that have none of these characteristics should be offered monitoring. Short-term initial ultrasound monitoring carries significant potential benefit in terms of aiding detection of early malignancy and avoidance of unnecessary surgery. However, if a mass remains stable but persistent, the potential benefit of ongoing monitoring wanes with time, whereas the potential harms, in terms of patient anxiety, cost, and the risk of incidental findings and unnecessary surgery increase. Therefore, monitoring of stable lesions should be limited in duration in order to limit potential harms from overtreatment and overdiagnosis.

Opportunistic Salpingectomy to Reduce the Risk of Ovarian Cancer

Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine whether the benefits are proportionate to the risks in a particular case.

Determination of Serum CA125 and evaluate its efficiency as screening tool For Early Detection of Ovarian Tumors

Epithelial ovarian cancer is the leading cause of cancer deaths in women. To date, an effective screening tool for ovarian cancer has not been identified Several clinical and biological factors including serum cancer antigen 125 (CA- 125) have been assessed for prognostic and predictive relevance CA-125 is an epithelial marker derived from coelomic epithelium. It is elevated in 90% of advanced ovarian cancers and in 50% of early ovarian cancers while 20% of ovarian cancers have low or no expression of CA- 125 CA-125 concentrations were measured by Mini Vidas test (VIDAS CA125 II / BIOMERIEUX / France). The median CA-125 levels were significantly higher in the sera of ovarian cancer patients than in those with benign tumors and in healthy controls. However in correlation with stages the results showed that Patients with stage II have highly significant differences in level of serum CA125 compare with stage I in and stage III.CA125 showed low sensitivity to detect stage I carcinoma of the ovary which limits its value as an initial screening tool therefore combining of CA125 with other markers might enable improved early detection of ovarian cancer as compared with use of this marker alone.

Determination of Serum CA125 and evaluate its efficiency as screening tool For Early Detection of Ovarian Tumors

Epithelial ovarian cancer is the leading cause of cancer deaths in women. To date, an effective screening tool for ovarian cancer has not been identified Several clinical and biological factors including serum cancer antigen 125 (CA- 125) have been assessed for prognostic and predictive relevance CA-125 is an epithelial marker derived from coelomic epithelium. It is elevated in 90% of advanced ovarian cancers and in 50% of early ovarian cancers while 20% of ovarian cancers have low or no expression of CA- 125 CA-125 concentrations were measured by Mini Vidas test (VIDAS CA125 II / BIOMERIEUX / France). The median CA-125 levels were significantly higher in the sera of ovarian cancer patients than in those with benign tumors and in healthy controls. However in correlation with stages the results showed that Patients with stage II have highly significant differences in level of serum CA125 compare with stage I in and stage III.CA125 showed low sensitivity to detect stage I carcinoma of the ovary which limits its value as an initial screening tool therefore combining of CA125 with other markers might enable improved early detection of ovarian cancer as compared with use of this marker alone.

HE4 combined with CA125: favorable screening tool for ovarian cancer

Ovarian cancer is one of the most prevalent malignancies in women. Screening of the disease is done using variety of biomarkers. Diagnostic performance of current biomarkers of the disease such as human epididymis protein (HE4) and CA125 shows contradiction in previous studies. The goal of this study was to evaluate serum levels of CA125 and HE4 in Iranian patients with ovarian cancer and compare specificity and sensitivity of HE4, CA125 and HE4 + CA125 in patients with different stages and diverse histology. To evaluate CA125 and HE4, 32 patients and 34 healthy women were selected. Origin of ovarian cancer was verified by expert gynecological oncologist. Significance and diagnostic performance were determined by ANOVA and receiver operator characteristic (ROC) and areas under the curve (AUC), respectively. Serum levels of CA125 and HE4 were significantly increased in patients in comparison with control group, especially for tumor cells originated from epithelium (p < 0.001). ROC-AUC for HE4, CA125 and HE4 + CA125 were 0.91, 0.86 and 0.91, respectively. Specificity of HE4 was more than CA125 (85 vs. 80 %). Conversely, sensitivity of CA125 was higher in comparison with HE4 (90 vs. 80 %). It is being noticed that cutoff point of HE4 and CA125 was 150 pmol/L and 38 U/mL, respectively. HE4 is slightly more specific for diagnosis of early stages of the disease, but the difference is not remarkable. CA125 and HE4 + CA125 have some diagnostic performance for prediction of advanced stages. Generally, the data of present study suggest that combining of HE4 and CA125 is a better screening tool for diagnosis of ovarian cancer.

Ovarian Volume throughout Life: A Validated Normative Model

The measurement of ovarian volume has been shown to be a useful indirect indicator of the ovarian reserve in women of reproductive age, in the diagnosis and management of a number of disorders of puberty and adult reproductive function, and is under investigation as a screening tool for ovarian cancer. To date there is no normative model of ovarian volume throughout life. By searching the published literature for ovarian volume in healthy females, and using our own data from multiple sources (combined n = 59,994) we have generated and robustly validated the first model of ovarian volume from conception to 82 years of age. This model shows that 69% of the variation in ovarian volume is due to age alone. We have shown that in the average case ovarian volume rises from 0.7 mL (95% CI 0.4–1.1 mL) at 2 years of age to a peak of 7.7 mL (95% CI 6.5–9.2 mL) at 20 years of age with a subsequent decline to about 2.8 mL (95% CI 2.7–2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis and management of a number of diverse gynaecological and reproductive conditions in females from birth to menopause and beyond.

IS RACE A PROGNOSTIC FACTOR IN DETERMINING OVARIAN CANCER SURVIVAL OUTCOMES? THE ANSWER IS NOT JUST BLACK AND WHITE

ObjectiveTo determine if there are disparities in survival outcomes in African–American (AA) and white American (WA) women who seek treatment for ovarian cancer in the USA.BackgroundAmong gynaecologic malignancies in the...

Assessing Baccalaureate Nursing Students' Knowledge of Ovarian Cancer

NURSES ARE IN A PRIME POSITION TO EDUCATE CLIENTS ABOUT HEALTH PROMOTION, SPECIFICALLY, CANCER RISK, PREVENTION, SYMPTOMS, AND EARLY DETECTION. However, cancer education in undergraduate nursing programs is often spread out among many courses and focused on the most common cancers (breast, lung, colon, and prostate). Cancers that affect a small number of individuals, such as ovarian cancer, may be overlooked.While early symptoms of ovarian cancer are recognized (Gynecologic Cancer Foundation, 2007), few health care professionals and lay people are aware of these symptoms (Lockwood- Rayermann, Donovan, Rambo, & Kuo, 2009). Eighty-five percent of women are diagnosed in advanced stages of the disease, contributing to its ranking as the fourth leading cause of cancer deaths for women (American Cancer Society, 2012). This article reports on the outcomes of a focused ovarian cancer awareness program for nursing students.Literature Review Studies of nursing students' knowledge of cancer are descriptive but show a knowledge deficit of early symptoms, cancer-related side effects and management (Frerichs & Varricchio, 1988), and pain management (Sheehan, Webb, Bower, & Einsporn, 1992). Recent studies have included educational interventions to improve knowledge about cancer pain (Wilkes, Lasch, Lee, Greenhill, & Chiri, 2003), skin cancer prevention (Siegel, 2010), and ovarian cancer (Fitch, McAndrew, Turner, Ross, & Pison, 2011). While all of these studies demonstrated that cancer knowledge can be improved with education, Fitch and colleagues reported that deficits still remained regarding symptoms and screening tests for ovarian cancer. Researchers did not examine long-term knowledge retention.Nurses Educational Initiative The Nurses Educational Initiative (NEI) is an educational program that expands on the Ovarian Cancer National Alliance's Survivors Teaching Students Program (2012). The NEI is a two-part interactive program involving faculty, students, and cancer survivors. Part 1 consists of an evidence-based lecture regarding ovarian cancer incidence, risk factors, screening guidelines, and symptoms; particular emphasis is placed on a Pap test not being an effective screening tool for ovarian cancer. To enhance the impact of the program, Part 2 consists of a presentation by one or more women who discuss their personal experiences with ovarian cancer. A question and answer period follows.Method A descriptive, one-gro up pre- and posttest design was used to examine the effectiveness of the NEI on baccalaureate nursing students' knowledge about ovarian cancer. Institutional review board approval was obtained prior to the start of the study. Students (N = 220) at a large state university in Florida participated at all three data collection time points. Data concerning knowledge were collected immediately prior to (Time 1) and immediately after the NEI (Time 2). Long-term knowledge retention was collected before graduation, 18 months after the NEI (Time 3). An investigator-developed instrument that directly reflected the evidence- based content presented during the NEI was used.Data were analyzed using descriptive statistics, frequencies, and paired t-tests using SPSS® version 18. Bonferroni's corrections were used, bringing the significance level to 0.017 (.05/3). Knowledge was measured by summing the number of correct answers on each survey. Answers were coded as: 0 = no, 1 = yes, with yes indicating the correct answer. The highest possible scores for each category are: total knowledge (19), incidence (1), risk (6), screening (2), symptoms (9), and most effective surgeon (1).Results Changes at all three time points were noted for overall knowledge and knowledge of risk, screening, and symptoms. For overall knowledge, mean baseline scores increased from 11.8 to 15.03 points at Time 2, but decreased to 12.74 points at Time 3. Mean risk scores were: baseline, 4.13 points; Time 2, 5. …

Ovarian status in healthy postmenopausal women

There are currently no programs to assess ovarian health in postmenopausal women. The aim of this study was to describe the ovaries in healthy women at least 5 years after menopause by questionnaire, transvaginal ultrasonography, and blood ovarian cancer markers. A total of 515 women who were asymptomatic and at the Stages of Reproductive Aging Workshop +2 stage of menopause (>5 y postmenopause) were recruited by advertisement. Clinical history was obtained by questionnaire, and biophysical assessment by a transvaginal ultrasound investigation and biochemical assessment by serum CA-125 and inhibin were performed. Abnormal findings were confirmed and then reviewed. Both ovaries were identified by transvaginal ultrasonography in 71% of women. The right ovary was visualized in 86.3% of these volunteers, and the left ovary was visualized in 78%. The presence of small unilocular cysts and echogenic foci facilitated identification of the ovary in some women. Ovarian/paraovarian lesions were present in 12.6% of women. Abnormalities of the endometrium and uterus were also common, prompting surgery in 7.2% of the women. Total serum inhibin concentrations were normal for postmenopausal women, whereas serum CA-125 was elevated in two women. We find that the description and detection of postmenopausal ovaries by transvaginal ultrasonography allows the identification of both ovaries in most postmenopausal women. Ultrasonography-detected abnormalities of the ovary and/or the uterus/endometrium are common in women at this stage of life. The potential need for surgical intervention after the detection of such abnormalities needs to be carefully evaluated when considering transvaginal ultrasonography as a screening tool for ovarian cancer.

Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high‐risk and population risk women is ineffective

To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer. Retrospective audit. NHS Trust. Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high-risk group (>10% lifetime risk of developing ovarian cancer), 77 in a moderate risk group (4-10% lifetime risk of developing ovarian cancer) and 71 in a near population risk group (<4% lifetime risk). Retrospective audit of case records, laboratory CA125 results, radiology reports, histology records and local cancer registry data. Ovarian cancers occurring in study population. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVU, and CA125 as a screening tool for ovarian cancer. Four ovarian cancers and one endometrial cancer occurred. One ovarian cancer was detected at surveillance, three occurred in women who presented symptomatically between screenings. Thirty women underwent exploratory surgery because of abnormal findings at surveillance. Two women had cancer (PPV = 6.7%); one had ovarian cancer and the other endometrial cancer. Twenty-eight women (93.3%) had no malignancy. Sensitivity, specificity, PPV and NPV for TVU in the whole cohort were 33.3, 85.8, 0.6 and 99.8%, respectively. For high-risk individuals, the figures for TVU were 33.3, 84.5, 1.1 and 99.6, respectively. Combining both modalities for the whole cohort, the sensitivity, specificity, PPV and NPV were 66.7, 82.9, 1.5 and 99.8% and 50.0, 82.8, 1.3 and 99.7%, respectively, for the high-risk group alone. Ovarian screening by annual TVU and CA125 is inefficient at detecting early-stage ovarian cancers.

Prognostic Factors for Stage III Epithelial Ovarian Cancer

We have no effective screening tools for ovarian cancer, in contrast to many other cancers. Thus, ovarian cancer usually is diagnosed after it has already progressed to stage III or IV. Despite aggressive measures, such as cytoreductive surgery and intravenous platinum-based chemotherapy, survival at 5 years among women with ovarian cancer is dismal. In the absence of a dedicated assay to quantify the incidence and rate of distant metastases, identification of factors that predict poor prognosis is of paramount importance. To investigate prognostic factors for advanced-stage …

Comparison of serum vascular endothelial growth levels between patients with and without ovarian malignancies

The objective of this study was to determine if there was a relationship between serum vascular endothelial growth factor (VEGF) levels and ovarian malignancies by contrasting a population with ovarian malignancies and a population free of gynecological neoplasms. Two hundred forty four serum samples were obtained from the US National Cancer Institute's Prostate, Lung, Colon, and Ovarian Cancer Screening Project. These samples were analyzed by enzyme-linked immunosorbent assays in duplicate, and on completion of the assays, the samples were decoded for age and disease type. Average VEGF values for the nongynecological control group was 4.399 ng/ml; for benign gynecologic cases, 2.515 ng/ml; and for patients with malignancies, 4.287 ng/ml. Specifically, there was no difference between the mean value of VEGF in patients with ovarian malignancies and the patients with benign gynecological tumors (P= 0.8823). Also, there was no difference between the mean value of VEGF in patients with ovarian malignancies and the control patients who did not have gynecological disease (P= 0.3110). Using the Mann–WhitneyU-test, no significant differences were found between the three populations of this study. Based on our data, due to the lack of significant difference in mean serum VEGF values between patients with and without ovarian malignancies, we feel that serum VEGF cannot be used as a possible screening tool for ovarian cancer.