OVARIAN CANCER SCREENING

Screening for ovarian cancer: a systematic review

Background

Ovarian cancer is the seventh most common cancer in women world wide. The overall five-year survival rate for women with ovarian cancer is poor. Survival is much better, however for women whose disease is localised to the ovaries, but only about a quarter of cases in the UK are currently diagnosed at this stage. This has led to interest in methods to detect ovarian cancer in asymptomatic women. The tests which have been most extensively evaluated as screening methods include ultrasound scanning, and the measurement of serum levels of CA125, a tumour marker produced by most ovarian cancers.

This review aimed to evaluate the performance of current screening tests for ovarian cancer; assess the adverse effects of screening; report on the stage of development of newer methods of screening; and investigate the potential cost-effectiveness of screening in different risk groups.

Findings

Further evidence, e.g. from the three large RCTs in progress, is required before a decision can be made about the potential benefits, harms and costs of screening for ovarian cancer. The relatively low prevalence of ovarian cancer means that the positive predictive value of screening tests is low. Since the consequence of a false-positive result is a surgical procedure, consideration of the overall impact of ovarian cancer screening is important. The low prevalence also limits the potential cost-effectiveness of population screening. Screening women who are at risk because of a strong family history may be more cost-effective but this has not been established.

Conducted by: R Bell1, M Petticrew1, S Luengo2, TA Sheldon1

1. NHS Centre for Reviews and Dissemination; 2. Health Services Research Unit, Instituto de Salud Carlos III

Further details

Project page on HTA Programme website

Publications

NHS Centre for Reviews and Dissemination. Screening for ovarian cancer: a systematic review. CRD Report 13. York: University of York. 1998

Bell R, Petticrew M, Sheldon TA, Luengo S. Screening for ovarian cancer: a systematic review. Health Technol Assess. 1998;2(2):1-84

Funding

Commissioned by the HTA Programme