Ovarian cancer screening

Abstract

Background: Current tests used in the diagnosis of ovarian cancer are the CA-125 blood test and transvaginal ultrasound.

Objective: This article discusses the available evidence and recommendations for ovarian cancer screening in both the general population, and in at risk women.

Discussion: General population screening is not recommended, however there is a large, randomised controlled trial currently underway investigating this. There is no data to support the effectiveness of screening in high risk women (carriers of BRCA1 or BRCA2 mutations, or carriers of mismatch repair gene mutations in the hereditary nonpolyposis colorectal cancer group) as most tumours detected by screening are at an advanced stage at diagnosis. Prophylactic surgery to remove the fallopian tubes and ovaries is recommended after the completion of childbearing to prevent 90% of ovarian cancers in these women. The remaining 10% of these tumours arise in the peritoneal cavity as primary peritoneal cancers and behave in a similar way to ovarian cancers, and, by definition, are advanced at diagnosis. The future holds hope of new screening tests becoming available.