Ovarian cancer screening – query bank

Question:  What is the evidence for and against screening for ovarian cancer?

Please note: the search for this response was carried out over 1 year ago. Eligible users may request an update of the evidence by submitting a new Clinical Query here.

Answer:

There are two large ongoing trials of ovarian cancer screening, but results are not expected for some time:

1. The UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)
The UK National Screening Committee policy  is that no screening should take place outside this trial.
A recent publication from the trial is:

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). / Menon U, Gentry-Maharaj A, Hallett R, Ryan A, Burnell M, Sharma A, Lewis S, Davies S, Philpott S, Lopes A, Godfrey K, Oram D, Herod J, Williamson K, Seif MW, Scott I, Mould T, Woolas R, Murdoch J, Dobbs S, Amso NN, Leeson S, Cruickshank D, McGuire A, Campbell S, Fallowfield L, Singh N, Dawnay A, Skates SJ, Parmar M, Jacobs I. The Lancet Oncology 2009 Vol 10(4) :327-40 Abstract

2. The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial from which there have been three publications:

  • Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial: Results from 4 years of annual screening in a randomized trial [abstract] / Partridge EE, Kreimer AR, Buys SS, Reding DJ, Fouad MN, Riley TL, Greenlee RT, Williams C, Prorok PC, Xu J-L Gyncologic Oncology 2007 Vol 104(3 Suppl 1): S14-15, Abstract 10
  • Cumulative false-positives in the prostrate, lung, colorectal, ovarian cancer screening trial [Abstract] / Miller JH, Kramer BS, Kreimer AR, Prorok PC, Xu J, Baker SG, Fagerstrom R, Berg CD, Gohagen JK
    Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I 2007 Vol 25 (18 Suppl): Abstract 1503. Abstracts of the 43rd Annual Meeting of the American Society of Clinical Oncology; 1-5 June 2007; Chicago, Illinois
  • Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial. / Buys SS, Partridge E, Greene MH, Prorok PC, Reding D, Riley TL, Hartge P, Fagerstrom RM, Ragard LR, Chia D, Izmirlian G, Fouad M, Johnson CC, Gohagan JK, PLCO Project Team. American journal of obstetrics and gynecology 2005 Vol 193(5): 1630-9 Abstract

(Evidence level Ib)

Two recent review articles about ovarian screening are listed below (1,2)

References:

  1. Ovarian cancer screening and early detection. / Joyner AB, Runowicz CD. Womens Health (Lond Engl). 2009 Nov;5(6):693-9 Abstract
  2. Clinical practice. Screening for ovarian cancer. / Clarke-Pearson DL. N Engl J Med. 2009 Jul 9;361(2):170-7.

Search date: March 2010

Classification of evidence levels

Ia Evidence obtained from meta-analysis of randomised controlled trials.

Ib Evidence obtained from at least one randomised controlled trial.

IIa Evidence obtained from at least one well-designed controlled study without randomisation.

IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.

III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.

IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.

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Date published: 24/03/2010

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