Update on ovarian cancer screening.
OBJECTIVE
Epithelial ovarian cancer is usually diagnosed in the advanced stage and carries a poor prognosis. When detected at an early stage, the 5-year survival rate is 90%. Despite the availability of various diagnostic tools for ovarian cancer screening, high levels of sensitivity and specificity are not achievable. There is therefore an ongoing need to identify new screening tests and strategies that should be readily available, relatively noninvasive, and achieve high sensitivity, specificity, and positive and negative predictive values.


RESULTS
Our review focuses on various screening technologies including serum biomarkers, transvaginal ultrasonography as well as multimodality screening that can be used for early detection of ovarian cancer. The efficacy of different screening tools is discussed along with the efforts made to improve sensitivity, specificity and positive predictive value. The initial results of two large population-based screening studies are presented.


CONCLUSIONS
An optimal screening test with high levels of sensitivity and specificity is indispensable for early detection of ovarian cancer. Serological screening with serum biomarkers (serum proteins and autoantibodies) can be used as a first-line screening test. In combination with TVS or color-flow Doppler imaging, this may prove very effective in early detection of ovarian cancer.
Munkarah
Adnan
A
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Wayne State University School of Medicine, Detroit, MI, USA.
Chatterjee
Madhumita
M
Tainsky
Michael A
MA
D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008403:Mass Screening; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen