Skip to main content

Advertisement

SpringerLink
Log in

The role of transvaginal ultrasonography for detecting ovarian cancer in an asymptomatic screening population: a systematic review

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to systematically analyze the effect of transvaginal ultrasonography in an asymptomatic female population as an annual screening procedure with regard to mortality data. Studies were evaluated descriptively on their strengths and weaknesses considering the methods and results.

Methods

We evaluated 632 international studies by selecting only randomized controlled trials (RCTs). Three RCTs concerning transvaginal ultrasonography were found, performed in Japan, the USA, and Great Britain.

Discussion

Currently, no clear recommendation for the screening for ovarian cancer in an asymptomatic population can be given based on these three studies. The authors could not show a change in mortality using transvaginal ultrasonography for annual screening.

Conclusion

An annual palpation does not offer a beneficial effect. The development of new ultrasound machines with higher image resolution in combination with a well-standardized algorithm for ovarian cancer in upcoming years might provide an improvement regarding mortality. The current studies do not show a benefit in screening an asymptomatic population annually with transvaginal ultrasonography, but the most recent publication showed a trend toward lower mortality in patients who underwent screening after 7–14 years of follow-up. Nevertheless, all three heterogeneous RCTs had weaknesses in their methods and therefore they neither contradict the general recommendation for screening in an asymptomatic population nor do they support it.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx. Accessed 23 Sept 2015

  2. Berek JS et al (2015) Cancer of the ovary, fallopian tube, and peritoneum. Int J Gynecol Obstet 131:S111–S122

    Article  Google Scholar 

  3. http://www.krebsdaten.de/Krebs/DE/Content/Krebsarten/Ovarialkrebs/ovarialkrebs_node.html. Accessed 16 Sept 2015

  4. Padilla LA, Radosevich DM, Milad MP et al (2000) Accuracy of the pelvic examination in detecting adnexal masses. Obstet Gynecol 96:593–598

    CAS  PubMed  Google Scholar 

  5. Ueland F, DePriest P, Pavlik E et al (2005) The accuracy of examination under anesthesia and transvaginal sonography in evaluating ovarian size. Gynecol Oncol 99:400–403

    Article  PubMed  Google Scholar 

  6. Ebell MH, Culp M, Lastinger K et al (2015) A systematic review of the bimanual examination as a test for ovarian cancer. Am J Prev Med 48(3):350–356

    Article  PubMed  Google Scholar 

  7. Leitlinie Deutschland. S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren. Accessed 3 Sept 2015

  8. Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    Article  CAS  PubMed  Google Scholar 

  9. Menon U, Kalsi J, Jacobs I et al (2012) The UKCTOCS experience-reasons for hope? Int J Gynecol Cancer 22(Suppl 1):S18–S20

    Article  PubMed  Google Scholar 

  10. Menon U, Gentry-Maharaj A, Hallett R et al (2009) Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers—results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Lancet Oncol 10(4):327–340

    Article  PubMed  Google Scholar 

  11. http://guidance.nice.org.uk/cg122. Accessed 18 Aug 2015

  12. Skates SJ, Menon U, MacDonald N et al (2003) Calculation of the risk of ovarian cancer from serial CA-125 values for preclinical detection in postmenopausal women. J Clin Oncol 21(10 Suppl):206s–210s

    Article  PubMed  Google Scholar 

  13. Skates SJ, Xu FJ, Yu YH et al (1995) Toward an optimal algorithm for ovarian cancer screening with longitudinal tumor markers. Cancer 76(10 Suppl):2004–2010

    Article  CAS  PubMed  Google Scholar 

  14. Timmerman D, Valentin L, Bourne TH et al (2000) Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol 16:500–505

    Article  CAS  PubMed  Google Scholar 

  15. Jacobs IJ, Menon U, Ryan A et al (2015) Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet. doi:10.1016/S0140-6736(15)01224-6 (Epub ahead of print)

  16. Partridge E, Kreimer AR, Greenlee RT et al (2009) Results from four rounds of ovarian cancer screening in a randomized trial. Obstet Gynecol 113(4):775–782

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Buys SS, Partridge E, Greene MH et al (2005) Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial—findings from the initial screen of a randomized trial. Am J Obstet Gynecol 193(5):1630–1639

    Article  PubMed  Google Scholar 

  18. NCCN Guidelines for Patients (2013) Ovarian cancer. Version 1. Accessed 13 Oct 2015

  19. http://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq. Accessed 13 Oct 2015

  20. http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-diagnosis. Accessed 13 Oct 2015

  21. Management of Adnexal Masses (2007) ACOG Practice Bulletin No. 83. American College of Obstetricians and Gynecologists. Obstet Gynecol 110:201–214

  22. Buys SS, Partridge E, Black A et al (2011) Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening randomized controlled trial. JAMA 305(22):2295–2303

    Article  CAS  PubMed  Google Scholar 

  23. Greenlee RT, Kessel B, Williams CR et al (2010) Prevalence, incidence and natural history of simple ovarian cysts among women over age 55 in a large cancer screening trial. Am J Obstet Gynecol 202(4):373.e1–373.e9

    Article  Google Scholar 

  24. Weissfeld JL, Fagerstrom RM, O’Brien B et al (2000) Prostate, lung, colorectal and ovarian cancer screening trial project team. Quality control of cancer screening examination procedures in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. Control Clin Trials 21(6 Suppl):390S–399S

    Article  CAS  PubMed  Google Scholar 

  25. Terada KY, Elia J, Kim R et al (2014) Abnormal CA-125 levels in menopausal women without ovarian cancer. Gynecol Oncol 135(1):34–37

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Pinsky PF, Zhu C, Skates SJ et al (2013) Potential effect of the risk of ovarian cancer algorithm (ROCA) on the mortality outcome of the Prostate, Lung, Colorectal and Ovarian (PLCO) trial. Int J Cancer 132(9):2127–2133

    Article  CAS  PubMed  Google Scholar 

  27. Partridge EE, Greenlee RT, Riley TL et al (2013) Assessing the risk of ovarian malignancy in asymptomatic women with abnormal CA125 and transvaginal ultrasound scans in the Prostate, Lung, Colorectal, and Ovarian Screening trial. Obstet Gynecol 121(1):25–31

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kobayashi H, Yamada Y, Sado T et al (2008) A randomized study of screening for ovarian cancer- a multicenter study in Japan. Int J Gynecol Cancer 18(3):414–420

    Article  CAS  PubMed  Google Scholar 

  29. Kwon JS, McGahan C, Dehaeck U et al (2014) The significance of combination chemotherapy in epithelial ovarian cancer. Int J Gynecol Cancer 24(2):226–232

    Article  PubMed  Google Scholar 

  30. Bentivegna E, Fruscio R, Roussin S et al (2015) Long-term follow-up of patients with an isolated ovarian recurrence after conservative treatment of epithelial ovarian cancer: review of the results of an international multicenter study comprising 545 patients. Fertil Steril. doi:10.1016/j.fertnstert.2015.06.008

  31. Van de Putte G, Oben J, Prenen L et al (2015) Outcome of epithelial ovarian cancer time for strategy trials to resolve the problem of optimal timing of surgery. Int J Gynecol Cancer 25(6):993–999

    Article  PubMed  Google Scholar 

  32. DePriest PD, Gallion HH, Pavlik EJ et al (1997) Transvaginal sonography as a screening method for the detection of early ovarian cancer. Gynecol Oncol 65(3):408–414

    Article  CAS  PubMed  Google Scholar 

Download references

Author contributions

KJB: project development, data collection or management, data analysis, and manuscript writing/editing. SL: project development, data collection or management, data analysis, and manuscript writing/editing. CE: project development, data collection or management, and data analysis. BS: manuscript writing/editing.

Author information

Author notes

    Authors and Affiliations

    1. Department of Gynecological Endocrinology, Clinic for Gynecology, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

      Kai J. Buhling & S. Lezon

    2. Institute for Medical Biometry and Epidemiology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

      C. Eulenburg

    3. Clinic for Gynecology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

      B. Schmalfeldt

    Authors
    1. Kai J. Buhling
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. S. Lezon
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. C. Eulenburg
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. B. Schmalfeldt
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Kai J. Buhling.

    Ethics declarations

    Conflict of interest

    All authors declare that they have no conflict of interest.

    Ethical approval

    This article does not contain any studies with human participants or animals performed by any of the authors.

    Additional information

    K. J. Buhling and S. Lezon contributed equally to this publication.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Buhling, K.J., Lezon, S., Eulenburg, C. et al. The role of transvaginal ultrasonography for detecting ovarian cancer in an asymptomatic screening population: a systematic review. Arch Gynecol Obstet 295, 1259–1268 (2017). https://doi.org/10.1007/s00404-017-4346-4

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00404-017-4346-4

    Keywords

    Search

    Navigation