Ovarian cancer screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

There are no recommendations for screening ovarian cancer in asymptomatic women although better outcome is associated with early diagnosis. Biomarkers from peritoneal fluid can be used as a mean of early detection of ovarian cancer but this is still an emerging proof. Examples of screening and diagnostic methods for ovarian cancer include pelvic examination, cancer antigen 125 (CA125) tumor marker, transvaginal ultrasound (TVU), multimarker panels, and bioinformatic analysis of proteomic patterns.

• There are no recommendations for screening ovarian cancer in asymptomatic women although better outcome is associated with early diagnosis.^[1][2]
• Ovarian cancer is the fifth most common cause of cancer-related mortality in women
• 75% of women with ovarian cancer are diagnosed in an advanced stage
• Ovarian cancer is the most lethal gynecological cancer
• The reason of increased mortality and late detection of ovarian cancer in its advanced stage is because the screening systems that are being used have poor or limited sensitivity and specificity.
• Biomarkers from peritoneal fluid can be used as a mean of ealy detection of ovarian cancer but this is still an emerging proof.
• Examples of screening and diagnostic methods for ovarian cancer include:^[3]
  • Pelvic examination
  • Cancer antigen 125 (CA 125) tumor marker
  • Transvaginal ultrasound (TVU)
  • Multimarker panels and bioinformatic analysis of proteomic patterns
• The UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)is evaluating a multimodal screening strategy (MMS) efficacy which consists of:
  • Annual CA125 screening, risk of ovarian cancer algorithm (ROCA), TVU
• Patients with family history of ovarian cancer or breast cancer can have ovarian cancer hereditary syndrome as breast-ovarian cancer syndrome which is associated with
  • BRCA1 and BRCA2 gene mutations
  • Lynch II syndrome
• Should undergo the following screening:
  • Annual rectovaginal pelvic examinations
  • CA125
  • TVU until completing childbearing or until age 35 years at least, where at this point prophylactic bilateral oophorectomy is recommended

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