Study: Ultrasound Most Important for Ovarian Cancer Detection
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LEXINGTON, Ky. (July 20, 2009) − Scientists at the University of Kentucky's Markey Cancer
Center have found that ultrasound findings form the single most important piece of
information for detecting ovarian cancer among women, exceeding symptoms analysis.
The findings were published online recently by the the journal Cancer.
Researchers led by Edward Pavlik, associate professor in the Division of Gynecologic Oncology at the UK College of Medicine, selected 272 women participating in annual trans-vaginal screening (TVS) from 31,748 women enrolled in a free screening project at the university and compared symptom results to ultrasound and surgical pathology findings. The team observed that TVS performed better for detecting malignancies, reporting 85 percent overall sensitivity versus 20 percent for symptoms analysis.
"Women want and should have access to screening for ovarian cancer," Pavlik said. We observed that only 20 percent of women with ovarian cancer detected by TVS reported symptoms, and this means that too high a reliance on symptoms information will miss four out of five ovarian cancers. Ignoring symptoms is not an option either, because they appear to be meaningful in 20 percent of ovarian cancers. The long-standing experience of the University of Kentucky Ovarian Cancer Screening team continues to be that TVS is the most effective way of discovering ovarian cancers at an early stage when this disease can be cured.”
While symptoms analysis performed better for distinguishing benign tumors (91.3 percent), overall TVS performed even better with 98.8 percent specificity. Adding symptom analysis to TVS actually resulted in poorer identification of malignancy (sensitivity = 16.7 percent), even as it improved the ability to distinguish benign tumors (specificity = 97.9 percent).
Pavlik says these observations suggest that even though symptoms do occur in some women with early stage ovarian malignancies, TVS will find a higher percentage of women with early stage disease. Informative symptoms can be expected to be absent in 80 percent of ovarian malignancies, Pavlik added.
The study was supported by the Telford Foundation and by the Kentucky Cabinet for Health and Human Services.
The findings were published online recently by the the journal Cancer.
Researchers led by Edward Pavlik, associate professor in the Division of Gynecologic Oncology at the UK College of Medicine, selected 272 women participating in annual trans-vaginal screening (TVS) from 31,748 women enrolled in a free screening project at the university and compared symptom results to ultrasound and surgical pathology findings. The team observed that TVS performed better for detecting malignancies, reporting 85 percent overall sensitivity versus 20 percent for symptoms analysis.
"Women want and should have access to screening for ovarian cancer," Pavlik said. We observed that only 20 percent of women with ovarian cancer detected by TVS reported symptoms, and this means that too high a reliance on symptoms information will miss four out of five ovarian cancers. Ignoring symptoms is not an option either, because they appear to be meaningful in 20 percent of ovarian cancers. The long-standing experience of the University of Kentucky Ovarian Cancer Screening team continues to be that TVS is the most effective way of discovering ovarian cancers at an early stage when this disease can be cured.”
While symptoms analysis performed better for distinguishing benign tumors (91.3 percent), overall TVS performed even better with 98.8 percent specificity. Adding symptom analysis to TVS actually resulted in poorer identification of malignancy (sensitivity = 16.7 percent), even as it improved the ability to distinguish benign tumors (specificity = 97.9 percent).
Pavlik says these observations suggest that even though symptoms do occur in some women with early stage ovarian malignancies, TVS will find a higher percentage of women with early stage disease. Informative symptoms can be expected to be absent in 80 percent of ovarian malignancies, Pavlik added.
The study was supported by the Telford Foundation and by the Kentucky Cabinet for Health and Human Services.