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Risk of epithelial ovarian cancer in asymptomatic women with ultrasound-detected ovarian masses: a prospective cohort study within the UK collaborative trial of ovarian cancer screening (UKCTOCS)

Sharma, A., Apostolidou, S., Burnell, M., Campbell, S., Habib, M., Gentry-Maharaj, A,, Amso, Nazar Najib, Seif, M. W., Fletcher, G., Singh, N., Benjamin, E., Brunell, C., Turner, G., Rangar, R., Godfrey, K., Oram, D., Herod, J., Williamson, K., Jenkins, H., Mould, T., Woolas, R., Murdoch, J., Dobbs, S., Leeson, S., Cruickshank, D., Fourkala, E.-O., Ryan, A., Parmar, M., Jacobs, I. and Menon, U. 2012. Risk of epithelial ovarian cancer in asymptomatic women with ultrasound-detected ovarian masses: a prospective cohort study within the UK collaborative trial of ovarian cancer screening (UKCTOCS). Ultrasound in Obstetrics and Gynecology 40 (3) , pp. 338-344. 10.1002/uog.12270

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Abstract

Objective. To estimate the risk of primary epithelial ovarian cancer (EOC) and slow growing borderline or Type I and aggressive Type II EOC in postmenopausal women with adnexal abnormalities on ultrasound. Methods. This was a prospective cohort study in the ultrasound group of the UK Collaborative Trial of Ovarian Cancer Screening of postmenopausal women with ultrasound-detected abnormal adnexal (unilocular, multilocular, unilocular solid and multilocular solid, solid) morphology on their first scan. Women were followed up through the national cancer registries and by postal questionnaires. Absolute risks of EOC and borderline, Type I and Type II EOC within 3 years of initial scan were calculated. Results. Of 48 053 women who underwent ultrasound examination and had complete scan data, 4367 (9.1% (95% CI, 8.8–9.3%)) had abnormal adnexal morphology. Median follow-up was 7.09 (25th–75th centiles, 6.03–7.92) years. Forty-seven (32 borderline or Type I, 15 Type II) were diagnosed with EOC. The overall absolute risk of EOC associated with abnormal adnexal morphology was 1.08% (95% CI, 0.79–1.43%); for borderline and Type I it was 0.73% (95% CI, 0.5–1.03%); and for Type II it was 0.34% (95% CI, 0.33–0.79%). In the subgroup (n = 741) with solid elements (unilocular solid, multilocular solid and solid) overall absolute risk was 4.45% (95% CI, 3.08–6.20%), for borderline and Type I it was 3.1% (95% CI, 1.9–4.6%) and for Type II it was 1.3% (95% CI, 0.6–2.4%). 11 982 women had both ovaries visualized and normal annual scans throughout the 3-year follow-up period. In this group, no borderline or Type I and eight Type II cancers were diagnosed. Conclusion. Asymptomatic postmenopausal women with ultrasound-detected adnexal abnormalities with solid elements have a 1 in 22 risk for EOC. Despite the higher prevalence of Type II EOC, the risk of borderline or Type I cancer in women with ultrasound abnormalities seems to be higher than does the risk of Type II cancer. This has important immediate implications for patients with incidental adnexal findings as well as for any future ultrasound-based screening.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: borderline ovarian cancer; ovarian cancer screening; ovarian cysts; ovarian neoplasm; postmenopausal women; risk; Type I/II epithelial ovarian cancer; UKCTOCS; ultrasound
Publisher: Wiley-Blackwell
ISSN: 0960-7692
Last Modified: 04 Jun 2017 05:32
URI: http://orca.cf.ac.uk/id/eprint/51848

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