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Ovarian Cancer Screening Mati Zolti M.D. Department of Obstetrics & Gynaecology Sheba Medical Center Tel Hashomer, Israel

Ovarian Cancer: Burden of suffering ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ovarian Cancer in Israel ,[object Object],[object Object],[object Object],[object Object]

Ovarian Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Types of Ovarian Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epithelial Ovarian Cancer ,[object Object],[object Object],[object Object]

Early Detection and Mortality ,[object Object],[object Object],[object Object],[object Object]

The challenge ,[object Object],[object Object],[object Object],[object Object]

Risk factors ,[object Object],[object Object]

Risk factors: Heredity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Additional Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Protective factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Delays in Diagnosis ,[object Object],[object Object],[object Object]

Diagnostic tools ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Work-up of Adnexal Mass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnostic approach ,[object Object],[object Object],[object Object]

Diagnostic Approach ,[object Object],[object Object]

Surgical Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Surgical Evaluation ,[object Object]

Treatment ,[object Object],[object Object],[object Object]

Surgical treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chemotherapy and Radiation ,[object Object],[object Object],[object Object]

Why screening for ovarian cancer is so difficult? ,[object Object],[object Object],[object Object],[object Object]

Screening Strategies ,[object Object],[object Object],[object Object],[object Object]

Ultrasound ,[object Object],[object Object],[object Object],[object Object]

Color-flow Doppler ,[object Object],[object Object],[object Object]

CA-125 ,[object Object],[object Object],[object Object]

CA-125 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lysophosphatidic acid (LPA) ,[object Object],[object Object],[object Object]

Current Screening Guidelines ,[object Object]

Screening Guidelines– cont’d ,[object Object],[object Object],[object Object],[object Object]

Screening, cont’d ,[object Object],[object Object],[object Object]

Where do we go from here? ,[object Object],[object Object],[object Object],[object Object]

Ovarian Cancer Screening Trials ,[object Object],[object Object],[object Object]

Take home points ,[object Object],[object Object],[object Object],[object Object],[object Object]

Marker Updates - Ca 125 • Approved marker to test for recurrence • Remains the single most sensitive and specific marker for ovarian cancer to date • Addition of other markers might improve sensitivity and specificity • Longitudinal assessment may also improve sensitivity and specificity

ROCA: Risk of Ovarian Cancer Algorithm

Marker Updates—OvaCheck ,[object Object],[object Object],[object Object],[object Object]

Marker Updates—Ciphergen Panel ,[object Object],[object Object]

Marker Updates - Yale’s Panel ,[object Object],[object Object],[object Object]

Marker Updates - Luminex Panel ,[object Object],[object Object],[object Object],[object Object]

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Editor's Notes