An effective ovarian cancer screening intervention still remains elusive…

This JAMA study is a stark reminder that we still do not have an effective way to screen for ovarian cancer. Despite multiple yearly ultrasounds and blood tests (see below) there was no survival advantage. False positive test results led to many invasive procedures with some associated complications.

“Findings: The study was designed to determine the effect of screening with transvaginal ultrasonography and serum cancer antigen 125 (CA-125) on ovarian cancer–related mortality. In the study, 68 557 women aged 55 to 74 years were randomly assigned to 4 annual transvaginal ultrasonography screenings and 6 annual CA-125 screenings (intervention group) or to usual care (usual care group). After a median follow-up of 12.4 years, the incidence of ovarian cancer in the intervention and usual care groups were 5.7 and 4.7 per 10 000 person-years, respectively (rate ratio, 1.21 [CI, 0.99 to 1.48]). The number of ovarian cancer–related deaths was 118 and 100, respectively (adjusted rate ratio, 1.18 [CI, 0.82 to 1.71]). No significant shift toward earlier-stage cancer was seen in the intervention group. False-positive results were shown in 3285 women (9.6% of the intervention group). Of these women, 1080 had surgical procedures and 163 experienced at least 1 serious complication.”

Screening for Ovarian Cancer With Transvaginal Ultrasonography and Serum Cancer Antigen 125 Does Not Reduce Mortality
Buys SS, Partridge E, Black A, et al; PLCO Project Team. Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial. JAMA. 2011;305:2295-303. [PMID: 21642681]

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