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Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data
Purpose To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening. Methods Real-world data were derived in the period of 20...
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| Published in: | Archives of gynecology and obstetrics 2022-01, Vol.305 (1), p.159-167 |
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| container_end_page | 167 |
| container_issue | 1 |
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| container_title | Archives of gynecology and obstetrics |
| container_volume | 305 |
| creator | Steinkasserer, Lena Irmgard, Delmarko Weiss, Tatjana Dirschlmayer, Walter Mossig, Michael Zeimet, Alain G. Marth, Christian |
| description | Purpose
To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening.
Methods
Real-world data were derived in the period of 2000–2017 from the Klinischen Tumorregister Austria. We estimated five-year overall survival (OS) of patients with ovarian cancer regarding different histological subtypes and FIGO stages. A theoretical model was generated predicting the trend of OS mediated by an eventual down-shifting of ovarian cancer from FIGO stage III/IV to FIGO stage I/II by screening, considering the influence of different histological subtypes.
Results
3458 ovarian cancer patients were subdivided according to histological subtypes and FIGO classification. Major difference in distribution of histological types was found between FIGO stage I/II and III/IV. A theoretical down-shift of tumors from high to low FIGO stages based on our registry calculations showed that the five-year OS would increase from 50% to nearly 80% by perfect screening.
Conclusion
In our simulation study, we showed that down-shifting ovarian cancers by successful screening might increase OS by 30 percentage point. Our results underscore the importance to recognize ovarian cancer as a heterogenous disease with distinct epidemiologic, molecular and clinical features. The individual characteristic of each histotype is of utmost impact on the definition of screening aims and may influence early detection and stage-shift. Efficacy of screening is mainly dependent on detection of high-risk cancer types and not the slow growing low-grade types. |
| doi_str_mv | 10.1007/s00404-021-06117-4 |
| format | article |
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To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening.
Methods
Real-world data were derived in the period of 2000–2017 from the Klinischen Tumorregister Austria. We estimated five-year overall survival (OS) of patients with ovarian cancer regarding different histological subtypes and FIGO stages. A theoretical model was generated predicting the trend of OS mediated by an eventual down-shifting of ovarian cancer from FIGO stage III/IV to FIGO stage I/II by screening, considering the influence of different histological subtypes.
Results
3458 ovarian cancer patients were subdivided according to histological subtypes and FIGO classification. Major difference in distribution of histological types was found between FIGO stage I/II and III/IV. A theoretical down-shift of tumors from high to low FIGO stages based on our registry calculations showed that the five-year OS would increase from 50% to nearly 80% by perfect screening.
Conclusion
In our simulation study, we showed that down-shifting ovarian cancers by successful screening might increase OS by 30 percentage point. Our results underscore the importance to recognize ovarian cancer as a heterogenous disease with distinct epidemiologic, molecular and clinical features. The individual characteristic of each histotype is of utmost impact on the definition of screening aims and may influence early detection and stage-shift. Efficacy of screening is mainly dependent on detection of high-risk cancer types and not the slow growing low-grade types.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-021-06117-4</identifier><identifier>PMID: 34125280</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Asymptomatic ; Austria - epidemiology ; Carcinoma, Ovarian Epithelial - pathology ; Early Detection of Cancer ; Endocrinology ; Female ; Gynecologic Oncology ; Gynecology ; Histology ; Hospitals ; Human Genetics ; Humans ; Medical screening ; Medicine ; Medicine & Public Health ; Mortality ; Neoplasm Staging ; Obstetrics ; Obstetrics/Perinatology/Midwifery ; Ovarian cancer ; Ovarian Neoplasms - pathology ; Womens health</subject><ispartof>Archives of gynecology and obstetrics, 2022-01, Vol.305 (1), p.159-167</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c425t-6323f6030b94e11af7ad6f437a0023a5b14842fb076c7c4ec248dfbd7f52179c3</cites><orcidid>0000-0002-8965-9981</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34125280$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steinkasserer, Lena</creatorcontrib><creatorcontrib>Irmgard, Delmarko</creatorcontrib><creatorcontrib>Weiss, Tatjana</creatorcontrib><creatorcontrib>Dirschlmayer, Walter</creatorcontrib><creatorcontrib>Mossig, Michael</creatorcontrib><creatorcontrib>Zeimet, Alain G.</creatorcontrib><creatorcontrib>Marth, Christian</creatorcontrib><title>Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening.
Methods
Real-world data were derived in the period of 2000–2017 from the Klinischen Tumorregister Austria. We estimated five-year overall survival (OS) of patients with ovarian cancer regarding different histological subtypes and FIGO stages. A theoretical model was generated predicting the trend of OS mediated by an eventual down-shifting of ovarian cancer from FIGO stage III/IV to FIGO stage I/II by screening, considering the influence of different histological subtypes.
Results
3458 ovarian cancer patients were subdivided according to histological subtypes and FIGO classification. Major difference in distribution of histological types was found between FIGO stage I/II and III/IV. A theoretical down-shift of tumors from high to low FIGO stages based on our registry calculations showed that the five-year OS would increase from 50% to nearly 80% by perfect screening.
Conclusion
In our simulation study, we showed that down-shifting ovarian cancers by successful screening might increase OS by 30 percentage point. Our results underscore the importance to recognize ovarian cancer as a heterogenous disease with distinct epidemiologic, molecular and clinical features. The individual characteristic of each histotype is of utmost impact on the definition of screening aims and may influence early detection and stage-shift. Efficacy of screening is mainly dependent on detection of high-risk cancer types and not the slow growing low-grade types.</description><subject>Asymptomatic</subject><subject>Austria - epidemiology</subject><subject>Carcinoma, Ovarian Epithelial - pathology</subject><subject>Early Detection of Cancer</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Gynecologic Oncology</subject><subject>Gynecology</subject><subject>Histology</subject><subject>Hospitals</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neoplasm Staging</subject><subject>Obstetrics</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Womens health</subject><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kctuFDEQRS0EIkPgB1ggS2zYNCmX3e0eFkgoCg8pEptkbVX7MXTUYw92d9D8PR4mhMciK9tVx9d1fRl7KeCtANBnBUCBagBFA50QulGP2EooiQ1oIR6zFawPe-j0CXtWyg2AwL7vnrITqQS22MOKuYsQRkt2z1PgFHnazeOWJp5uKY_1bClan3mx2fs4xs07TnzwZW4sFV_LPlYu8TIvbs-HWnM8RZ49Tc2PlCfHHc30nD0JNBX_4m49ZdcfL67OPzeXXz99Of9w2ViF7dx0EmXoQMKwVl4ICppcF5TUBICS2kGoXmEYQHdWW-Utqt6FwenQotBrK0_Z-6Pubhm23tXh5kyT2eVqKe9NotH824njN7NJt6bXff0NrAJv7gRy-r5Um2Y7Vo_TRNGnpRhsFWhcCzygr_9Db9KSY7VnsEPRo1QoKoVHyuZUSvbhfhgB5hCiOYZoaojmV4hG1Uuv_rZxf-V3ahWQR6DUVtz4_OftB2R_AmGJp5U</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Steinkasserer, Lena</creator><creator>Irmgard, Delmarko</creator><creator>Weiss, Tatjana</creator><creator>Dirschlmayer, Walter</creator><creator>Mossig, Michael</creator><creator>Zeimet, Alain G.</creator><creator>Marth, Christian</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8965-9981</orcidid></search><sort><creationdate>20220101</creationdate><title>Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data</title><author>Steinkasserer, Lena ; Irmgard, Delmarko ; Weiss, Tatjana ; Dirschlmayer, Walter ; Mossig, Michael ; Zeimet, Alain G. ; Marth, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-6323f6030b94e11af7ad6f437a0023a5b14842fb076c7c4ec248dfbd7f52179c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Asymptomatic</topic><topic>Austria - epidemiology</topic><topic>Carcinoma, Ovarian Epithelial - pathology</topic><topic>Early Detection of Cancer</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Gynecologic Oncology</topic><topic>Gynecology</topic><topic>Histology</topic><topic>Hospitals</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neoplasm Staging</topic><topic>Obstetrics</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Ovarian cancer</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steinkasserer, Lena</creatorcontrib><creatorcontrib>Irmgard, Delmarko</creatorcontrib><creatorcontrib>Weiss, Tatjana</creatorcontrib><creatorcontrib>Dirschlmayer, Walter</creatorcontrib><creatorcontrib>Mossig, Michael</creatorcontrib><creatorcontrib>Zeimet, Alain G.</creatorcontrib><creatorcontrib>Marth, Christian</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Databases</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steinkasserer, Lena</au><au>Irmgard, Delmarko</au><au>Weiss, Tatjana</au><au>Dirschlmayer, Walter</au><au>Mossig, Michael</au><au>Zeimet, Alain G.</au><au>Marth, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2022-01-01</date><risdate>2022</risdate><volume>305</volume><issue>1</issue><spage>159</spage><epage>167</epage><pages>159-167</pages><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening.
Methods
Real-world data were derived in the period of 2000–2017 from the Klinischen Tumorregister Austria. We estimated five-year overall survival (OS) of patients with ovarian cancer regarding different histological subtypes and FIGO stages. A theoretical model was generated predicting the trend of OS mediated by an eventual down-shifting of ovarian cancer from FIGO stage III/IV to FIGO stage I/II by screening, considering the influence of different histological subtypes.
Results
3458 ovarian cancer patients were subdivided according to histological subtypes and FIGO classification. Major difference in distribution of histological types was found between FIGO stage I/II and III/IV. A theoretical down-shift of tumors from high to low FIGO stages based on our registry calculations showed that the five-year OS would increase from 50% to nearly 80% by perfect screening.
Conclusion
In our simulation study, we showed that down-shifting ovarian cancers by successful screening might increase OS by 30 percentage point. Our results underscore the importance to recognize ovarian cancer as a heterogenous disease with distinct epidemiologic, molecular and clinical features. The individual characteristic of each histotype is of utmost impact on the definition of screening aims and may influence early detection and stage-shift. Efficacy of screening is mainly dependent on detection of high-risk cancer types and not the slow growing low-grade types.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34125280</pmid><doi>10.1007/s00404-021-06117-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8965-9981</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Asymptomatic Austria - epidemiology Carcinoma, Ovarian Epithelial - pathology Early Detection of Cancer Endocrinology Female Gynecologic Oncology Gynecology Histology Hospitals Human Genetics Humans Medical screening Medicine Medicine & Public Health Mortality Neoplasm Staging Obstetrics Obstetrics/Perinatology/Midwifery Ovarian cancer Ovarian Neoplasms - pathology Womens health |
| title | Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data |
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