Volunteer acceptance of transvaginal scanning - United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) experience

Objective To assess pain and overall experience of transvaginal ultrasound scanning (TVS) in asymptomatic postmenopausal women. Methods In UKCTOCS, 50,639 postmenopausal women were randomised to undergo annual TVS at 13 trial centres in England, Wales and Northern Ireland. Together with the appointment letter for their annual scan, a random sample of 150 women per centre was sent a detailed 48-item postal questionnaire regarding the screening experience. It included a specific question about pain using a 0-5 score where 5 was severe pain and 3 was discomfort. To assess factors that might affect a volunteer's reported pain experience, the pain score was regressed on age, HRT use, BMI, history of hysterectomy, prolonged scanning time, ovarian visualisation, scan result, sonographer's visualisation rates, opinion of the women regarding the sonographer who performed the scan. Results Between 7(th) July and 9(th) September 2009, 1950 randomly chosen women (150 per regional centre) were sent the questionnaire. Of the 800 (41.0%) who returned the questionnaire, 651 could be linked to their TVS appointment. 152 (23.3%) women reported pain/discomfort (score 3-5) during TVS and 473 (72.7%) no discomfort (score 0-2). Only 23 (3.5%) women reported experiencing moderate/severe pain. Increasing discomfort/pain was independently related with history of hysterectomy and participant's reporting of prolonged scan time. Women who experienced pain on TVS were less compliant (OR = 0.87) with the following year's scan compared to those who did not. Conclusions Majority of postmenopausal women found TVS acceptable. Pain influenced compliance and correlated with women's perception of increased scanning time and previous hysterectomy. Copyright (c) 2012 ISUOG. Published by John Wiley & Sons, Ltd.