Yale Early Detection Program For Ovarian Cancer

The ovary is the fifth most common site for cancer to develop in American women. However, it is the fourth leading cause of cancer deaths in American women. There are more deaths from ovarian cancer than from cervical and uterine cancers combined. The American Cancer Society estimates that 23,100 new cases of ovarian cancer will develop in the year 2000 and 14,000 will die from this disease. Dramatic improvements have occurred in the treatment of patients with ovarian cancer leading to prolonged survival. However, dramatic improvements in the cure rate from this aggressive cancer have remained elusive.

Studies at Yale University School of Medicine have established that the patient at highest risk for ovarian cancer is a women with a first degree relative, i.e. a mother, sister or a daughter who has had ovarian cancer. Also at high risk are women with a great number of ovulatory cycles. Pregnancy, oral contraceptive use and early age of menopause reduces the number of ovulatory cycles and the potential risk for ovarian cancer. Women who have not had children are at the highest risk for developing ovarian cancer. A Yale University study established that women in Connecticut who have had no children had five times the risk of developing ovarian cancer than women who have had five or more pregnancies. A woman who has had one or two pregnancies has twice the risk of a woman who has had five pregnancies. The greater the number of children, the less the number of ovulatory cycles and the lower the risk for developing ovarian cancer.

An early detection program for ovarian cancer was established at Yale University in 1990 in order to identify (1) which screening tests are the most appropriate for detecting early ovarian cancer, (2) what frequency the tests should be employed and (3) what are the variations from the norm of these tests in a population study. Ultimately, we wish to identify ovarian cancer in its early stages when it is highly curable rather than in the more advanced stages when overwhelmingly treatment is palliative. Women participating in the Yale Early Detection Program for Ovarian Cancer must have (1) a first degree relative(s) who has experienced ovarian cancer and (2) be over age 30. Participants fill out a very extensive personal history and family history form. They then are entered into our program, are interviewed by a medical social worker and nurse practitioner and undergo a complete physical examination by a gynecologic oncologist (a physician special trained in the treatment of gynecologic cancers). Blood tests are obtained, looking for circulating molecules that serve as markers for ovarian cancer. Participants are asked to return in six months and one year following the initial evaluation for repeat physical examinations and tumor marker studies. In the intervening three and nine month periods of time, participants have state-of-the-art transvaginal ultrasound examinations and color Doppler flow studies. These studies have proved useful in distinguishing benign tumors from ovarian malignancies and are now being used by our group to detect early ovarian cancer before it has produced any symptoms or has spread. Participants are re-evaluated on an every 6 month basis thereafter with alternating physical examinations and ultrasounds as well as tumor marker studies. Women participating in this program are also at an increased risk for developing breast cancer. Participants are urged to participate in an annual mammography program beginning at age 40.

Participation in the Yale Early Detection Program for Ovarian Cancer is voluntary.

For further information, please call the Yale Early Detection Program for Ovarian Cancer at 203-785-4014 or download the Yale Early Detection Program for Ovarian Cancer Form.

The office hours are from 8:30-5:00 Monday-Friday. Patients are seen in the Yale Physicians Building at 800 Howard Avenue, New Haven, CT. The phone number for appointments is 203-785-4176.