Skip to main content

Advertisement

Log in

Contemporary progress in ovarian cancer screening

  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Our limited understanding of the natural biology of ovarian cancer, along with its low prevalence in the general population make early detection especially challenging. To be successful at the population level, an ovarian cancer screening test must prove its beneficial effect on ovarian cancer-specific mortality while achieving near-perfect specificity in order to minimize the harms resulting from false-positive results. No current screening tests for ovarian cancer fulfill these expectations. We review the current status and the challenges of ovarian cancer screening in the context of evidence-based principles that define a valuable cancer screening program.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Holschneider CH, Berek JS: Ovarian cancer: epidemiology, biology, and prognostic factors. Semin Surg Oncol 2000, 19:3–10.

    Article  PubMed  CAS  Google Scholar 

  2. Schwartz LM, Woloshin S, Fowler FJ Jr, Welch HG: Enthusiasm for cancer screening in the United States. JAMA 2004, 291:71–78.

    Article  PubMed  CAS  Google Scholar 

  3. Brawley OW, Kramer BS: Cancer screening in theory and in practice. J Clin Oncol 2005, 23:293–300.

    Article  PubMed  Google Scholar 

  4. Wilson JMG, Junger G: Principles and Practice of Screening for Disease. Public Health Papers. Geneva: World Health Organization; 1968.

    Google Scholar 

  5. Goff BA, Mandel L, Muntz HG, Melancon CH: Ovarian carcinoma diagnosis. Cancer 2000, 89:2068–2075.

    Article  PubMed  CAS  Google Scholar 

  6. Jacobs IJ, Menon U: Progress and challenges in screening for early detection of ovarian cancer. Mol Cell Proteomics 2004, 3:355–366.

    Article  PubMed  CAS  Google Scholar 

  7. Hogg R, Friedlander M: Biology of epithelial ovarian cancer: implications for screening women at high genetic risk. J Clin Oncol 2004, 22:1315–1327.

    Article  PubMed  Google Scholar 

  8. Berchuck A, Iversen ES, Lancaster JM, et al.: Patterns of gene expression that characterize long-term survival in advanced stage serous ovarian cancers. Clin Cancer Res 2005, 11:3686–3696.

    Article  PubMed  CAS  Google Scholar 

  9. Horiuchi A, Itoh K, Shimizu M, et al.: Toward understanding the natural history of ovarian carcinoma development: a clinicopathological approach. Gynecol Oncol 2003, 88:309–317.

    Article  PubMed  Google Scholar 

  10. Bell DA, Scully RE: Early de novo ovarian carcinoma. A study of fourteen cases. Cancer 1994, 73:1859–1864.

    Article  PubMed  CAS  Google Scholar 

  11. Campbell S, Bhan V, Royston P, et al.: Transabdominal ultrasound screening for early ovarian cancer. BMJ 1989, 299:1363–1367.

    Article  PubMed  CAS  Google Scholar 

  12. Timmerman D, Testa AC, Bourne T, et al.: Logistic regression model to distinguish between the benign and malignant adnexal mass before surgery: a multicenter study by the International Ovarian Tumor Analysis Group. J Clin Oncol 2005, 23:8794–8801.

    Article  PubMed  Google Scholar 

  13. Ueland FR, DePriest PD, Pavlik EJ, et al.: Preoperative differentiation of malignant from benign ovarian tumors: the efficacy of morphology indexing and Doppler flow sonography. Gynecol Oncol 2003, 91:46–50.

    Article  PubMed  CAS  Google Scholar 

  14. Alcazar JL, Merce LT, Laparte C, et al.: A new scoring system to differentiate benign from malignant adnexal masses. Am J Obstet Gynecol 2003, 188:685–692.

    Article  PubMed  Google Scholar 

  15. van Nagell JR Jr, DePriest PD, Reedy MB, et al.: The efficacy of transvaginal sonographic screening in asymptomatic women at risk for ovarian cancer. Gynecol Oncol 2000, 77:350–356.

    Article  PubMed  Google Scholar 

  16. Fishman DA, Cohen L, Blank SV, et al.: The role of ultrasound evaluation in the detection of early-stage epithelial ovarian cancer. Am J Obstet Gynecol 2005, 192:1214–1221; discussion 1221–1212.

    Article  PubMed  Google Scholar 

  17. Liede A, Karlan BY, Baldwin RL, et al.: Cancer incidence in a population of Jewish women at risk of ovarian cancer. J Clin Oncol 2002, 20:1570–1577.

    Article  PubMed  Google Scholar 

  18. Bast RC Jr, Feeney M, Lazarus H, et al.: Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest 1981, 68:1331–1337.

    Article  PubMed  Google Scholar 

  19. Woolas RP, Xu FJ, Jacobs IJ, et al.: Elevation of multiple serum markers in patients with stage I ovarian cancer. J Natl Cancer Inst 1993, 85:1748–1751.

    Article  PubMed  CAS  Google Scholar 

  20. Moss EL, Hollingworth J, Reynolds TM: The role of CA125 in clinical practice. J Clin Pathol 2005, 58:308–312.

    Article  PubMed  CAS  Google Scholar 

  21. Jacobs IJ, Skates SJ, MacDonald N, et al.: Screening for ovarian cancer: a pilot randomised controlled trial. Lancet 1999, 353:1207–1210.

    Article  PubMed  CAS  Google Scholar 

  22. Skates SJ, Menon U, MacDonald N, et al.: Calculation of the risk of ovarian cancer from serial CA-125 values for preclinical detection in postmenopausal women. J Clin Oncol 2003, 21:206–210.

    Article  Google Scholar 

  23. Menon U, Skates SJ, Lewis S, et al.: Prospective study using the risk of ovarian cancer algorithm to screen for ovarian cancer. J Clin Oncol 2005, 23:7919–7926.

    Article  PubMed  Google Scholar 

  24. Buys SS, Partridge E, Greene MH, et al.: Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial. Am J Obstet Gynecol 2005, 193:1630–1639.

    Article  PubMed  Google Scholar 

  25. Rosenthal AN, Menon U, Jacobs IJ: Screening for ovarian cancer. Clin Obstet Gynecol 2006, 49:433–447.

    Article  PubMed  Google Scholar 

  26. Rosen DG, Wang L, Atkinson JN, et al.: Potential markers that complement expression of CA125 in epithelial ovarian cancer. Gynecol Oncol 2005, 99:267–277.

    Article  PubMed  CAS  Google Scholar 

  27. Bast RC Jr: Status of tumor markers in ovarian cancer screening. J Clin Oncol 2003, 21:200–205.

    Article  Google Scholar 

  28. Rapkiewicz AV, Espina V, Petricoin EF III, Liotta LA: Biomarkers of ovarian tumours. Eur J Cancer 2004, 40:2604–2612.

    Article  PubMed  CAS  Google Scholar 

  29. McIntosh MW, Urban N, Karlan B: Generating longitudinal screening algorithms using novel biomarkers for disease. Cancer Epidemiol Biomarkers Prev 2002, 11:159–166.

    PubMed  Google Scholar 

  30. Meri S, Baumann M: Proteomics: posttranslational modifications, immune responses and current analytical tools. Biomol Eng 2001, 18:213–220.

    Article  PubMed  CAS  Google Scholar 

  31. Mok SC, Chao J, Skates S, et al.: Prostasin, a potential serum marker for ovarian cancer: identification through microarray technology. J Natl Cancer Inst 2001, 93:1458–1464.

    Article  PubMed  CAS  Google Scholar 

  32. Draghici S, Chatterjee M, Tainsky MA: Epitomics: serum screening for the early detection of cancer on microarrays using complex panels of tumor antigens. Expert Rev Mol Diagn 2005, 5:735–743.

    Article  PubMed  CAS  Google Scholar 

  33. Posadas EM, Davidson B, Kohn EC: Proteomics and ovarian cancer: implications for diagnosis and treatment: a critical review of the recent literature. Curr Opin Oncol 2004, 16:478–484.

    Article  PubMed  CAS  Google Scholar 

  34. Sellers TA, Yates JR: Review of proteomics with applications to genetic epidemiology. Genet Epidemiol 2003, 24:83–98.

    Article  PubMed  Google Scholar 

  35. Petricoin EF, Ardekani AM, Hitt BA, et al.: Use of proteomic patterns in serum to identify ovarian cancer. Lancet 2002, 359:572–577.

    Article  PubMed  CAS  Google Scholar 

  36. Sorace JM, Zhan M: A data review and re-assessment of ovarian cancer serum proteomic profiling. BMC Bioinformatics 2003, 4:24.

    Article  PubMed  Google Scholar 

  37. Diamandis EP: Analysis of serum proteomic patterns for early cancer diagnosis: drawing attention to potential problems. J Natl Cancer Inst 2004, 96:353–356.

    Article  PubMed  Google Scholar 

  38. Kozak KR, Amneus MW, Pusey SM, et al.: Identification of biomarkers for ovarian cancer using strong anion-exchange ProteinChips: potential use in diagnosis and prognosis. Proc Natl Acad Sci U S A 2003, 100:12 343–12 348.

    Article  CAS  Google Scholar 

  39. Zhang Z, Bast RC Jr, Yu Y, et al.: Three biomarkers identified from serum proteomic analysis for the detection of early stage ovarian cancer. Cancer Res 2004, 64:5882–5890.

    Article  PubMed  CAS  Google Scholar 

  40. Kozak KR, Su F, Whitelegge JP, et al.: Characterization of serum biomarkers for detection of early stage ovarian cancer. Proteomics 2005, 5:4589–4596.

    Article  PubMed  CAS  Google Scholar 

  41. Ye B, Cramer DW, Skates SJ, et al.: Haptoglobin-alpha subunit as potential serum biomarker in ovarian cancer: identification and characterization using proteomic profiling and mass spectrometry. Clin Cancer Res 2003, 9:2904–2911.

    PubMed  CAS  Google Scholar 

  42. Mor G, Visintin I, Lai Y, et al.: Serum protein markers for early detection of ovarian cancer. Proc Natl Acad Sci U S A 2005, 102:7677–7682.

    Article  PubMed  CAS  Google Scholar 

  43. Ness RB, Grisso JA, Klapper J, et al.: Risk of ovarian cancer in relation to estrogen and progestin dose and use characteristics of oral contraceptives. SHARE Study Group. Steroid Hormones and Reproductions. Am J Epidemiol 2000, 152:233–241.

    Article  PubMed  CAS  Google Scholar 

  44. Rebbeck TR, Lynch HT, Neuhausen SL, et al.: Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 2002, 346:1616–1622.

    Article  PubMed  Google Scholar 

  45. van Nagell JR Jr, Gallion HH, Pavlik EJ, DePriest PD: Ovarian cancer screening. Cancer 1995, 76:2086–2091.

    Article  PubMed  Google Scholar 

  46. Vuento MH, Pirhonen JP, Makinen JI, et al.: Evaluation of ovarian findings in asymptomatic postmenopausal women with color Doppler ultrasound. Cancer 1995, 76:1214–1218.

    Article  PubMed  CAS  Google Scholar 

  47. Sato S, Yokoyama Y, Sakamoto T, et al.: Usefulness of mass screening for ovarian carcinoma using transvaginal ultrasonography. Cancer 2000, 89:582–588.

    Article  PubMed  CAS  Google Scholar 

  48. Einhorn N, Sjovall K, Knapp RC, et al.: Prospective evaluation of serum CA 125 levels for early detection of ovarian cancer. Obstet Gynecol 1992, 80:14–18.

    PubMed  CAS  Google Scholar 

  49. Grover S, Quinn MA, Weideman P, et al.: Screening for ovarian cancer using serum CA125 and vaginal examination: report on 2550 females. Int J Gynecol Cancer 1995, 5:291–295.

    Article  PubMed  Google Scholar 

  50. Skates SJ, Horick N, Yu Y, et al.: Preoperative sensitivity and specificity for early-stage ovarian cancer when combining cancer antigen CA-125II, CA 15-3, CA 72-4, and macrophage colony-stimulating factor using mixtures of multivariate normal distributions. J Clin Oncol 2004, 22:4059–4066.

    Article  PubMed  Google Scholar 

  51. Gorelik E, Landsittel DP, Marrangoni AM, et al.: Multiplexed immunobead-based cytokine profiling for early detection of ovarian cancer. Cancer Epidemiol Biomarkers Prev 2005, 14:981–987.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christine S. Walsh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Walsh, C.S., Karlan, B.Y. Contemporary progress in ovarian cancer screening. Curr Oncol Rep 9, 485–493 (2007). https://doi.org/10.1007/s11912-007-0068-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-007-0068-2

Keywords

Navigation