FDG-PET/CT There is currently no evidence to support the use of FDG-PET/CT for ovarian cancer screening in premenopausal women without risk factors. Variant 2: Ovarian cancer screening. Postmenopausal. Average risk. US US has been the most heavily investigated imaging modality for ovarian cancer screening to date, both alone and in conjunction with biomarker screening of serum CA-125. 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. A recent meta-analysis [15] of 10 randomized trials of ovarian cancer screening using US and/or serum CA-125 measurements found that the included trials did not demonstrate a significant reduction in mortality. Below we describe the studies that are Ovarian Cancer Screening most relevant for decision making concerning ovarian cancer screening in average-risk postmenopausal women. The majority were designed to accrue a dominant population of average-risk postmenopausal women. However, across studies, exclusion criteria intended to exclude high-risk women were heterogeneous. In the University of Kentucky Ovarian Cancer Screening Study, investigators deliberately also included a subset of premenopausal high-risk women, as detailed below. Of note, the methodologic detail provided in the studies described below does not allow for uniform determination of the use, or potential benefits, of color Doppler. Therefore, the benefits of US performed with, versus without, color Doppler cannot be determined. Shizuoka District (Japan) Trial In 2008, Kobayashi et al [17] published a randomized controlled trial in which postmenopausal women were randomized to a control group (n = 40,799) or to five screening rounds of CA-125 and US (n = 41,688). US was predominantly performed using a transvaginal approach.
Ovarian Cancer Screening. FDG-PET/CT There is currently no evidence to support the use of FDG-PET/CT for ovarian cancer screening in premenopausal women without risk factors. Variant 2: Ovarian cancer screening. Postmenopausal. Average risk. US US has been the most heavily investigated imaging modality for ovarian cancer screening to date, both alone and in conjunction with biomarker screening of serum CA-125. 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. A recent meta-analysis [15] of 10 randomized trials of ovarian cancer screening using US and/or serum CA-125 measurements found that the included trials did not demonstrate a significant reduction in mortality. Below we describe the studies that are Ovarian Cancer Screening most relevant for decision making concerning ovarian cancer screening in average-risk postmenopausal women. The majority were designed to accrue a dominant population of average-risk postmenopausal women. However, across studies, exclusion criteria intended to exclude high-risk women were heterogeneous. In the University of Kentucky Ovarian Cancer Screening Study, investigators deliberately also included a subset of premenopausal high-risk women, as detailed below. Of note, the methodologic detail provided in the studies described below does not allow for uniform determination of the use, or potential benefits, of color Doppler. Therefore, the benefits of US performed with, versus without, color Doppler cannot be determined. Shizuoka District (Japan) Trial In 2008, Kobayashi et al [17] published a randomized controlled trial in which postmenopausal women were randomized to a control group (n = 40,799) or to five screening rounds of CA-125 and US (n = 41,688). US was predominantly performed using a transvaginal approach.