# Combination of transvaginal ultrasound with cervical cancer screening contributes to early detection of ovarian cancer: Clinical trial

## TL;DR

Combining transvaginal ultrasound with cervical cancer screening helps detect ovarian cancer early, especially in its initial stage.

## Contribution

The study shows that combining TVU with cervical screening improves early detection of ovarian cancer, particularly type I tumors.

## Key findings

- 81.6% of detected ovarian cancers were at stage I, indicating early detection.
- Type I tumors were more likely to be detected at stage I compared to type II tumors.

## Abstract

Early detection of ovarian cancer at stage I is important to improve patients‘ prognosis. The goal of this study was to examine if transvaginal ultrasound (TVU) performed at the same time as cervical cancer screening can facilitate early detection of ovarian cancer.

From 2014 to 2022, 483 269 women underwent TVU examinations during cervical cancer screening. The criteria for abnormal findings on TVU were ovarian enlargement ≥3 cm in long diameter (≥2 cm in postmenopausal women).

Of the 483 269 women who underwent TVU, 3294 (0.68%) were selected for detailed examination. Of these women, 550 underwent surgery and 80 cases of ovarian cancer were found (positive predictive value: 2.43%). Pathologic review in 76 of these cases showed 70 cases of epithelial ovarian cancer (type I: 54 [77.1%], Type II: 16 [22.9%]) and six cases of non‐epithelial malignant tumors. Clinical staging analysis showed that 81.6% (62 cases) were at stage I. Significantly more type I than type II tumors were detected at stage I (87.3% (n = 46) vs. 56.3%, P = 0.0068 (n = 9)). Notably, 95.7% (22/23) of clear cell carcinoma cases were detected at stage I.

The high rate of early detection of type I ovarian cancer might be due to its slow progression. In Asia, where type I is common, the benefits of screening for ovarian cancer are particularly great. However, screening with TVU has generally been considered to have little benefit. The results of this study suggest a need for reassessment of this view.