Screening for ovarian cancer

The increased survival advantage for patients diagnosed with early stage ovarian cancer suggests that screening programs that detect early stage disease might have an impact on disease mortality. Attempts are being made to develop effective screening methods for early ovarian cancer in women without symptoms, using a variety of serum tumour markers, proteomic patterns and ovarian vascular and morphological features. Three main screening strategies have emerged, one utilising transvaginal scanning as the primary test (ultrasound strategy), one involving measurement of the serum tumour marker CA125 as the primary test with transvaginal scanning as the secondary test (multimodal strategy) and another utilising both transvaginal scanning and measurement of CA125 together as both a primary and secondary test (combined strategy). Large randomised trials are now underway to provide definitive data on the impact of screening on mortality and address morbidity, health economics and psychosocial issues.