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Abstract
Ovarian cancer is currently the most common leading cause of death
among the gynecologic malignancies. Its prevalence in the population,
and the fact that diagnosis at an earlier stage leads to markedly improved
survival, makes it an ideal candidate for a screening program. However,
to date, trials of screening programs have not been shown to have any
effect on mortality from the disease and screening presents several
challenges. First, a distinct precursor lesion for ovarian cancer has not
been identified. Second, identification of the appropriate groups in the
general population to be selected for screening is problematic. Third,
detection of early stage disease requires developing tests with high
sensitivity and specificity.
Trials have incorporated multimodal screening protocols which
utilize transvaginal ultrasound and measurement of serum CA125 levels.
Either to be use concurrently, or one of them as first line, and the other as
second line. Serum CA125 as the first line and transvaginal ultrasound as
the secondary line achieved a high specificity and positive predictive
value and can positively impact the survival.