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Screening for ovarian cancer

N D MacDonald1, A N Rosenthal, I J Jacobs

  • 1Ovarian Cancer Screening Unit, St. Bartholomew's Hospital, London, UK.

Annals of the Academy of Medicine, Singapore
|January 27, 1999
PubMed
Summary

Ovarian cancer screening shows promise for early detection in postmenopausal women. Combining tumor markers like CA 125 with ultrasound offers high accuracy and cost-effectiveness, warranting further clinical trials.

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Area of Science:

  • Gynecologic Oncology
  • Medical Screening Technologies
  • Tumor Marker Diagnostics

Background:

  • Ovarian cancer is often diagnosed late in postmenopausal women, leading to poor survival rates (<30% 5-year).
  • Early-stage detection significantly improves survival, highlighting the need for effective ovarian cancer screening.
  • Challenges in screening include the ovaries' inaccessibility and lack of a defined premalignant state.

Purpose of the Study:

  • To evaluate the potential of novel screening strategies for early ovarian cancer detection.
  • To assess the efficacy of advanced tumor marker analysis and imaging techniques.
  • To determine the most effective and cost-efficient approach for ovarian cancer screening.

Main Methods:

  • Utilizing sequential CA 125 tumor marker measurements with a mathematical algorithm for risk assessment.
  • Employing transvaginal ultrasound, Doppler, and morphological indices for imaging-based screening.
  • Investigating multimodal screening combining tumor markers and ultrasound.

Main Results:

  • Sequential CA 125 analysis with risk algorithms improves sensitivity for asymptomatic postmenopausal women.
  • Transvaginal ultrasound alone shows promise but lacks the specificity for general population screening.
  • Multimodal screening demonstrates high sensitivity and specificity, proving to be the most cost-effective strategy.

Conclusions:

  • Advances in tumor marker interpretation and ultrasound technology make ovarian cancer screening feasible.
  • Multimodal screening combining CA 125 and ultrasound is a promising strategy with sufficient accuracy for trials.
  • Large-scale clinical trials are underway to confirm if these screening methods can reduce ovarian cancer mortality.

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