Maybe The findings from a study in the United Kingdom indicate that ovarian cancer screening is effective in women 50 to 74 years of age. Findings from a US National Cancer Institute-funded study, on the other hand, suggest that it is ineffective in a similar group of postmenopausal women.
Menon U, Gentry-Maharaj A, Hallett R, et al. Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Lancet Oncol. 2009;10:327–340.
Partridge E, Kreimer AR, Greenlee RT, et al, for the PLCO Project Team. Results from four rounds of ovarian cancer screening in a randomized trial. Obstet Gynecol. 2009;113:775–782.
EXPERT COMMENTARY
Andrew M. Kaunitz, MD Professor and Associate Chairman, Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville. Dr. Kaunitz serves on the OBG Management Board of Editors.
In the US study, the poor performance of screening may be due, in part, to universal rather than selective use of TVS; that modality generates substantially more false positives than does CA 125. The US study also defined an ovarian abnormality more broadly (volume greater than 10 cm3) than the British study did (volume greater than 60 cm3), which may have lowered the PPV in the US trial.
As investigators in the UK continue to follow participants and report their findings, we will learn more about the value of MMS, including its impact on cancer mortality, possibly as soon as 2014.
WHAT THIS EVIDENCE MEANS FOR PRACTICE
Until we have further data on the value of ovarian cancer screening in postmenopausal women, we should continue the current practice of screening only symptomatic or very-high-risk women for ovarian cancer.—ANDREW M. KAUNITZ, MD
