Cortesi L, et al. – The effectiveness of transvaginal ultrasound (TVU) and serum CA–125 measurement in women at different risk of developing ovarian cancer/fallopian tube cancer (OC/FTC) and the incidence of primary peritoneal cancer (PPC) after risk–reducing salpingo–oophorectomy (RRSO) had been assessed. In this study, the effectiveness of the surveillance program for early diagnosis was supported by the cancer detection rate in women with BRCA mutation or a strong family history. No screening was advised for women at lower risk of OC/FTC.

Methods

• 661 women at different risk of OC/FTC/PPC due to a family history or BRCA1/2 gene mutation were offered TVU and CA-125 measurement or RRSO as prevention strategies, between 2002 and 2014.
• Researchers assessed the detection rate of OC/FTC/PPC, and the sensitivity and specificity for CA-125 measurement and TVU were calculated.
• They conducted survival and event analysis for diagnosed patients. 

Results

• 12 OC/FTC/PPC cases were detected (2.6/1,000 persons/year), after a median follow-up of 112 months.
• With 73% for BRCA carriers, the screening sensitivity was 70%.
• In addition, six (50%) of 12 cancers were stage I or II.
• 2 BRCA1 carriers developed a PPC (4.9%), among 41 women who underwent RRSO.
• Overall and event-free survival were 75 and 64%, at 61-month follow-up.