Expert Commentary

Is ovarian Ca screening effective in postmenopausal women?

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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

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