ovarian cancer screening recommendations - maheshraj84

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Asymptomatic women- No Screening

Women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes- Referral for genetic counseling and evaluation for BRCA testing.

1. Risk factors: aged > 60 years; low parity; personal history of endometrial, colon, or breast cancer; family history of ovarian cancer; and hereditary ovarian cancer syndrome. Use of oral contraceptives decreases risk of ovarian cancer.
2. Benefit: There is inadequate evidence to determine whether routine screening for ovarian cancer with serum markers such as CA 125 levels, transvaginal ultrasound, or pelvic examinations would result in a decrease in mortality from ovarian cancer. Harm: Based on solid evidence, routine screening for ovarian cancer would result in many diagnostic laparoscopies and laparotomies for each ovarian cancer found.
3. Preliminary results from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial: At the time of baseline exam, positive predictive value for invasive cancer was 3.7% for an abnormal CA 125, 1% for an abnormal transvaginal ultrasound, and 23.5% if both tests were abnormal.

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no family h/o-- no screening

family h/o positive but distant relative---- once a year CA-125 and Trans vaginal ultrasound


family h/o positive in first degree relative--- test BRCA 1 BRCA 2 genes this once for lifetime
twice in a year CA-125 and TVS