Screening for the Early Detection of Ovarian Cancer

Evaluation of: Menon U, Gentry-Maharaj A, Hallett R et al.: Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Lancet Oncol. 10, 327–340 (2009). A randomized, controlled trial was undertaken to assess the use of serum CA125 and ovarian ultrasound as diagnostic markers in the early detection of ovarian cancer. The trial consisted of 202,638 postmenopausal women who were assessed annually between 2001 and 2005. A nonscreen group and two screening groups were investigated. The screening groups included serum CA125, which was based on a rate-of-change algorithm, plus transvaginal ultrasound (in at-risk women); and an ovarian ultrasound group only, prior to clinical review and surgery. The sensitivity, specificity and positive predictive values for all primary ovarian and tubal cancers for the combined test group was 89.4, 99.8 and 43.3%, respectively, and for the ultrasound group 84.9, 98.2 and 5.3%, respectively, with a significant difference in specificity between groups. The combined test provides the requisite specificity for a screening test for ovarian cancer in postmenopausal women.