Four criteria may confirm ovarian ca.(NEWS)

PALM SPRINGS, CALIF. -- The best predictor for ovarian malignancy in a postmenopausal woman with an initial abnormal screen is a CA 125 level greater than or equal to 65 U/mL, Dr. Edward E. Partridge said at the annual meeting of the Society of Gynecologic Oncologists.

He also reported that in women who have a follow-up screen, these four criteria, in hierarchical order, appear to be accurate in detecting malignancy: a CA 125 level greater than or equal to 65 U/mL; a CA 125 increase of 40 points or more; a CA 125 change of 10 points with an ovary and/or cyst 3 cm or greater in size; or an ovary/cyst change of 6.5 cm or more.

The findings are based on an analysis of data from the first 3 years of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

"This should provide some guidance for clinical decisions regarding the need for surgery and/or appropriate referral for asymptomatic postmenopausal women with abnormal findings on CA 125 and/or transvaginal ultrasound," said Dr. Partridge, associate director of cancer prevention and control at the University of Alabama, Birmingham, and director of the UAB Comprehensive Cancer Center.

However, he was quick to note that he does not recommend the routine clinical use of CA 125 and transvaginal ultrasound to detect ovarian cancer in asymptomatic postmenopausal women at this time. "We are not encouraging these tests until the trial is complete," he said. "If one does have these tests it gives some reassurance that you do not have to undergo an operative procedure if these criteria are not met."

While the study is the largest of its kind to date, the criteria used in the analysis "are empirically based and represent one approach to combine the criteria," Dr. Partridge added. "The model has not been validated in a separate, similar population. Therefore it may be overly optimistic in its predictability."

The purpose of the study was to quantify and characterize the occurrence of ...