Screening for Epithelial Ovarian Cancer: An Updated Review

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Abstract

Introduction

Epithelial ovarian cancer is an aggressive malignancy causing significant number of deaths across the world. The disease has much better prognosis if detected early and treated appropriately. The present article reviewed various screening options and their efficacies.

Results

Traditionally, the ovarian cancer screening strategies have relied on transvaginal ultrasound (TVS) of pelvis and serum CA-125 estimation. However, the randomized controlled trials evaluating these tests to screen the average-risk women annually failed to demonstrate any significant reduction in mortality among the screened women compared to the unscreened. On the other hand, the false positive women underwent unnecessary surgeries and resulting complications. The recently published results of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) demonstrated delayed mortality benefits (7–14 years after screening) in the women undergoing multi-modality screening (MMS). Women undergoing MMS were assigned a risk score using an ovarian cancer risk algorithm (ROCA), and the women with intermediate or high risk had repeat CA-125 estimation, and those with high risk had TVS. The reduction in the incidence of ovarian cancer and mortality from the disease through screening is likely to be more significant with the longer follow-up of the UKCTOCS trial. However, the feasibility and cost-effectiveness of such intensive screening need to be evaluated.

Conclusion

Currently, ovarian cancer screening is not recommended for the average-risk population.

Keywords

Ovarian cancer Screening CA-125 antigen Randomized controlled trial 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Association of Gynecologic Oncologists of India 2017

Authors and Affiliations

  1. 1.Screening Group, International Agency for Research on CancerWorld Health OrganizationLyon Cedex 08France

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