Table 1.

Criteria for a Positive Screening Examination and Classification of Diagnostic Follow-Up Procedures

Diagnostic Follow-Up Procedures
Screening ModalityDefinition of a Positive Screening ResultMinimally Invasive ProceduresModerately Invasive ProceduresMajor Surgical Procedures
CA-125 = cancer antigen 125; CXR = chest radiograph; DRE = digital rectal examination; FSG = flexible sigmoidoscopy; PSA = prostate-specific antigen; TVU = transvaginal ultrasonography.
a Assuming a perfect sphere and using the prolate ellipsoid formula, this volume correlates to an approximate diameter of 2.67 cm. A 10-cc cutoff was chosen, as it corresponds to 2 standard deviations above mean ovarian volume for postmenopausal women.24
b We define a true-positive FSG as both overt cancer and advanced adenomas (lesions with villous histologic findings, severe cellular dysplasia, and/or ≥1 cm in diameter).
PSA>4 ng/mLEndoscopyBiopsyProstatectomy
Transurethral resection of the prostate (TURP)
DREOne or more of the following findings:As for PSAAs for PSAAs for PSA
    Loss of anatomic landmarks
CA-125>35 U/mLColonoscopyBiopsyHysterectomy
Intra-abdominal washingsOophorectomy
LaparoscopyOvarian lymphadenectomy (with laparotomy)
TVUOne or more of the following findings:As for CA-125As for CA-125As for CA-125
    Ovary or cyst >10 cca
    Solid area or papillary projection extending into the cavity of a cystic ovarian tumor of any size
    Mixed (solid/cystic) component within a cystic ovarian tumor
CXROne or more of the following findings:BronchoscopyBiopsyLung resection
    Hilar or mediastinal lymph node enlargementThoracoscopy
    Major atelectasis or lobar collapseTransbronchial aspiration
    Infiltrate, consolidation, or alveolar opacityTransthoracic aspiration
FSGOne or more of the following findingsb:Colonoscopy (with- out biopsy)BiopsyColon resection
    Rectal nodule(s)CystoscopyHemicolectomy
    Rectal and/or colon mass(es)EndoscopyLymphadenectomyLaparotomy
    Colon polyp(s)Rigid sigmoidoscopy