Ovarian cancer screening.
In an ongoing effort to design an efficacious, cost-effective ovarian cancer screening method, the existing tests, CA 125 and transvaginal sonography, are being optimized and combined in a multimodal strategy, and new promising serum markers, such as mesothelin and HE4, are being developed and evaluated. Detection has been found to improve when multiple serum markers are used in a longitudinal logarithm. The parametric empirical Bayes approach improves screening algorithms by capturing the stability of markers over time in a heterogeneous population. It also has relatively simple extensions to multiple markers. The evaluation of markers increasingly accounts for characteristics of a woman that may affect her marker levels and accounts for the cancer's characteristics, histology, and grade. Receiver operating characteristic curves are helpful for evaluation because they relate a marker's sensitivity to the specificity at which it operates. Large, well-designed randomized controlled trials are under way to gauge the performance of existing screening methods.
Urban
Nicole
N
Cancer Prevention Research Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, MP-900, 1100 Fairview Avenue North, Seattle, WA 98109-1024, USA. nurban@fhcrc.org
McIntosh
Martin W
MW
Andersen
Marin
M
Karlan
Beth Y
BY
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006023:Glycoproteins; D006801:Humans; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood; D008403:Mass Screening; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D011506:Proteins; D012680:Sensitivity and Specificity
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D006023:Glycoproteins; C086414:OVX1 antigen; D011506:Proteins; D016173:Macrophage Colony-Stimulating Factor