CT has a limited role in the evaluation of adnexal lesions and would be an impractical screening modality because of its poor discriminatory ability between benign and malignant adnexal lesions and the associated risks of ionizing radiation. FDG-PET/CT To our knowledge, there have been no trials evaluating the use of FDG-PET/CT as an ovarian cancer screening tool in high-risk women. FDG-PET/CT has poor performance in this setting and is impractical as a screening modality. Ovarian Cancer Screening Variant 4: Ovarian cancer screening. Postmenopausal. High risk (personal history or family history or known or suspected genetic predisposition or elevated CA-125). US Most studies discussed in this document have addressed the use of transvaginal US. In general, transabdominal US should be reserved for women in whom transvaginal US is not technically feasible, or used as a complement to transvaginal US. To our knowledge, randomized controlled trials analogous to those in average-risk populations have not been conducted in definitively high-risk populations. Several related studies have been reported, all relatively small in sample size and most of which include a mix of premenopausal and postmenopausal women at high risk [29-33]. In 2006, Lacey et al [35] performed a secondary analysis of PLCO data to compare, within the screening arm, differences in screening outcomes (after the first four rounds of screening) between women of varying risk for ovarian cancer. Risk was classified based on personal history of breast cancer and family history of breast or ovarian cancer. Although the PPV of screening was marginally higher for women in specified moderate- and high-risk groups compared to those at average risk (PPV of 1.3% and 1.6% in the moderate- and high-risk groups, respectively, compared to 0.7% in the average-risk group), this difference was not statistically significant.
Ovarian Cancer Screening. CT has a limited role in the evaluation of adnexal lesions and would be an impractical screening modality because of its poor discriminatory ability between benign and malignant adnexal lesions and the associated risks of ionizing radiation. FDG-PET/CT To our knowledge, there have been no trials evaluating the use of FDG-PET/CT as an ovarian cancer screening tool in high-risk women. FDG-PET/CT has poor performance in this setting and is impractical as a screening modality. Ovarian Cancer Screening Variant 4: Ovarian cancer screening. Postmenopausal. High risk (personal history or family history or known or suspected genetic predisposition or elevated CA-125). US Most studies discussed in this document have addressed the use of transvaginal US. In general, transabdominal US should be reserved for women in whom transvaginal US is not technically feasible, or used as a complement to transvaginal US. To our knowledge, randomized controlled trials analogous to those in average-risk populations have not been conducted in definitively high-risk populations. Several related studies have been reported, all relatively small in sample size and most of which include a mix of premenopausal and postmenopausal women at high risk [29-33]. In 2006, Lacey et al [35] performed a secondary analysis of PLCO data to compare, within the screening arm, differences in screening outcomes (after the first four rounds of screening) between women of varying risk for ovarian cancer. Risk was classified based on personal history of breast cancer and family history of breast or ovarian cancer. Although the PPV of screening was marginally higher for women in specified moderate- and high-risk groups compared to those at average risk (PPV of 1.3% and 1.6% in the moderate- and high-risk groups, respectively, compared to 0.7% in the average-risk group), this difference was not statistically significant.