Ovarian cancer screening: potential effect on mortality

Article Abstract:

Screening for cervical cancer using the Pap smear is associated with reduced death rates. Mammography is leading to earlier detection of breast cancer with no effect yet seen on mortality. The benefits of screening for ovarian cancer are currently being debated and research to develop such a test is underway. The reduction in ovarian cancer mortality that might result from such a test was evaluated. A hypothetical test was assumed to be capable of identifying 80 percent of all women with ovarian cancer, a rate similar to that of the Pap smear. About 20,000 cases of ovarian cancer occur per year in the US, and 85 percent occur in women over 45 years. Of these 20,000 women, 7,600 are expected to survive five years; most deaths from ovarian cancer occur within three years of diagnosis. The severity of ovarian cancer is assessed by stage, with survival being best in those with stage I disease. Young women have better survival rates because they tend to be diagnosed at early stages, and their survival is better than older women within the same stage. A screening test (with 80 percent sensitivity) that tested all women would increase the number of five-year survivors to about 14,400, with the survival rate for women over 45 almost doubling. Even though the mortality of older women would be halved with universal screening, these results would be difficult to obtain unless at least 100,000 women were evaluated for at least six years. This type of screening is unlikely to achieve the maximum predicted benefit, as most women do not use currently available screening tests. Resources might be better directed at identifying subgroups at high risk for the disease, developing tests that are very specific, and developing tests that are inexpensive. Younger patients who are worried about the disease can reduce their risk by nearly half by using oral contraceptives. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Ovarian cancer, Medical screening, Health screening

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Chronic lymphocytic leukemia in pregnancy

Article Abstract:

Chronic lymphocytic leukemia may be an unusual disease in a pregnant woman. Blood tests performed for a 16 weeks' gestation prenatal visit revealed a very high white blood cell count in a 30-year-old woman. The fetus was developing normally, but the mother was diagnosed with B-cell lymphocytic leukemia. She delivered a healthy baby girl at 35 weeks, and her white cell count had dropped by the time of her six week postpartum visit. The woman was still healthy one year later. Chronic lymphocytic leukemia is usually found in elderly men and is somewhat benign.

Case studies, Physiological aspects, Pregnancy, Lymphocytic leukemia

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Risk factors for hyperplasia-associated versus atrophy-associated endometrial carcinoma

Article Abstract:

Hyperplasia-associated endometrial cancer may have different risk factors than atrophy-associated endometrial cancer. In a study of 76 women with endometrial cancer, longer exposures to estrogen were linked to hyperplasia-associated cancer but not atrophy-associated cancer.

Risk factors, Endometrial cancer

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