Van Nagell, J.R., Jr., DePriest, P.D., Puls, L.E., Donaldson, E.S., Gallion, H.H., Pavlik, E.J., Powell, D.E., and Kryscio, R.J.
It is estimated that 20,700 cases of ovarian cancer will be diagnosed in the US this year, and that 12,500 women will die of this disease. The cure rate for Stage I ovarian cancer may be as high as 90 percent, but because the disease causes no symptoms in its early stages, the majority of cases are diagnosed late. In more advanced stages, five-year survival rates fall to 15 or 20 percent. It is estimated that if the fraction of cases diagnosed in early stages could be increased to 80 percent the mortality rate could be cut in half. One method for improving the diagnosis of early stage ovarian cancer is by screening using transvaginal ultrasonography. With this method, a ultrasonic sound generator is inserted into the vagina to obtain a clearer image than can be obtained from the body's surface. The ultrasound image is then used to calculate the volume of the ovaries. An abnormally large volume or an unusual echo is indication for further tests. The efficacy of this method for early screening was evaluated in 1,300 postmenopausal women without any history of pelvic tumors. Transvaginal ultrasonography revealed ovarian abnormalities in 33 patients; 27 of these patients underwent exploratory laparotomy, the opening of the abdomen for direct examination of the tissues. All 27 patients had some sort of ovarian tumor. The most common finding was the serous cystadenoma, a benign tumor, which was observed in 14 cases. However, malignant adenocarcinoma of the ovary was found in two patients. In both cases, the Stage I cancer was undetectable by physical examination or by blood tests for tumor markers. Both patients were successfully treated and are alive and well. During follow-up, none of the other patients had negative findings on the imaging screening test developed ovarian cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)