난소암의 조기진단

Abstract

Ovarian cancer is the leading cause of death from gynecologic malignancies. In 1992, it has been reported that the incidence of ovarian cancer was 3% of all female malignancies in Korea. During the last decade, the incidence of cervical cancer which is the most common one of female malignancies was gradually declining, however that of ovarian cancer tended to be slightly increasing probably because of changes in socioeconomic status of this country. Despite of aggressive debulking operation and intensive platinum-based combination chemotherapy, the overall survival rate for ovarian cancer has not changed appreciably over the last twenty years. One of the reasons for poor prognosis of ovarian cancer is that greater than 70% of patients with ovarian cancer is unfortunately detected after the disease has already spreaded beyond the pelvis because of the lack of early symptoms. The cure rate for these patients with advanced ovarian cancer is only 15-20%, This low survival rate is in marked contrast to that of as high as 90% with stage I disease. Therefore, development of early detection method for ovarian cancer would be the best way to reduce the mortality rate of this disease.

Ultrasonography and serum tumor marker, CA 125 have been extensively studied for early detection of ovarian cancer. Recently, combined use of transvaginal color Doppler technique is studied to increase the specificity of the screening test. However, the value of these methods as a screening test is still debating. So far, unfortunately there is no conclusive method which has cost-effectiveness and perfect sensitivity and specificity for ovarian cancer screening. Moreover, the optimal population and interval for ovarian cancer screening are not currently defined. In this review, recent data of studies using ultrasound and serum marker, CA 125 and debating issues for ovarian cancer screening are discussed.

Ovarian cancer is the leading cause of death from gynecologic malignancies. In 1992, it has been reported that the incidence of ovarian cancer was 3% of all female malignancies in Korea. During the last decade, the incidence of cervical cancer which is the most common one of female malignancies was gradually declining, however that of ovarian cancer tended to be slightly increasing probably because of changes in socioeconomic status of this country. Despite of aggressive debulking operation and intensive platinum-based combination chemotherapy, the overall survival rate for ovarian cancer has not changed appreciably over the last twenty years. One of the reasons for poor prognosis of ovarian cancer is that greater than 70% of patients with ovarian cancer is unfortunately detected after the disease has already spreaded beyond the pelvis because of the lack of early symptoms. The cure rate for these patients with advanced ovarian cancer is only 15-20%, This low survival rate is in marked contrast to that of as high as 90% with stage I disease. Therefore, development of early detection method for ovarian cancer would be the best way to reduce the mortality rate of this disease.

Ultrasonography and serum tumor marker, CA 125 have been extensively studied for early detection of ovarian cancer. Recently, combined use of transvaginal color Doppler technique is studied to increase the specificity of the screening test. However, the value of these methods as a screening test is still debating. So far, unfortunately there is no conclusive method which has cost-effectiveness and perfect sensitivity and specificity for ovarian cancer screening. Moreover, the optimal population and interval for ovarian cancer screening are not currently defined. In this review, recent data of studies using ultrasound and serum marker, CA 125 and debating issues for ovarian cancer screening are discussed.