EP23.33: Transvaginal colour Doppler ultrasound in early diagnosis of ovarian cancer: a 24‐ year experience

Ovarian cancer mortality remains high mainly due to late diagnosis. Since 1999, we have performed colour Doppler transvaginal (CDTV) ultrasound to screen for ovarian cancer. The purpose of this paper is to assess the efficiency of CDTV ultrasound to detect ovarian cancer in early stages. Screening by CDTV ultrasound was annually performed in asymptomatic women with no family history of ovarian cancer. Women with abnormal screenings had repeat tests after four to six weeks. If the finding remitted, CDTV ultrasound follow-up was performed at one year. If the abnormality persisted, the study was completed with tumour markers, CT scan, and laparoscopy. A total of 815.127 CDTV ultrasound screenings performed in 198.044 women were reviewed. Malignant tumours were diagnosed and histologically confirmed in 130 patients. Borderline lesions were detected in 58 of them (46%). The mean age of the patients was 47 years (±12). Ninety three (73,8%) of these tumours were in stage I (including two cases of Fallopian tube carcinoma); eight were in stage II; 25 were in stage III; and four lesions detected were metastases. Sixty percent of the patients had normal levels of CA 125, measured after the lesions were detected by CDTV ultrasound study. Although consensus about the benefits of transvaginal ultrasound as a screening procedure is not unanimous, our data suggest that tumours in patients screened with CDTV ultrasound are detected at earlier stages. Additional randomised studies are needed to support these findings.