Screening for ovarian cancer: a pilot randomised controlled trial

Area of Science:

• Oncology
• Gynecologic Oncology
• Screening and Diagnostics

Background:

• The clinical utility of ovarian cancer screening remains uncertain.
• A pilot randomized trial was conducted to evaluate a multimodal screening strategy.

Purpose of the Study:

• To assess the feasibility of a multimodal screening approach for ovarian cancer.
• To evaluate the effectiveness of sequential CA 125 antigen testing and ultrasonography.

Main Methods:

• Postmenopausal women (≥45 years) were randomized to a control or screened group.
• Screened women received annual CA 125 tests; ultrasound and gynecological referral were based on specific thresholds.
• Follow-up occurred over 7 years to identify invasive epithelial ovarian/fallopian tube cancers.

Main Results:

• The positive predictive value of screening was 20.7%, detecting 6 cancers among 29 referrals.
• Median survival for detected cancers was longer in the screened group (72.9 months) vs. control (41.8 months).
• No significant difference in deaths from index cancers between groups (RR 2.0 [95% CI 0.78-5.13]).

Conclusions:

• Multimodal ovarian cancer screening is feasible in a randomized trial setting.
• The findings support the need for larger trials to determine if screening impacts ovarian cancer mortality.