[Screening for ovarian carcinoma]

Approximately 1 in 70 women in the USA will develop ovarian cancer in their lifetime. As the incidence of ovarian cancer is higher than that of cervical cancer, an effective screening program is indicated from a medical point of view. This article examines the reduction in ovarian cancer mortality that might be achieved if we can develop a screening test for the detection of this disease during its preclinical phase. Until recently the only potential screening test for ovarian cancer was vaginal examination. With pelvic examination small ovarian lesions are often missed. Ultrasound examination of the ovaries is a much more reliable method for examining the ovary than gynecologic palpation. The combination of serum CA125 measurement with ultrasound examination offers the most specific and sensitive method for the early detection of ovarian cancer. Question concerning the optimal population to screen remain unanswered. If a screening protocol for ovarian cancer is available, demonstration that it results in a reduction in mortality in the screened population will be required. This will only be obtained by performing a large population based, randomised controlled study. Therefore, a simple and reliable screening test for the early detection of ovarian cancer is still urgently required.