Ovarian Cancer Screening: A Look at the Evidence

Abstract

In 2005, more than 22,000 American women were diagnosed with ovarian cancer and 16,000 women died from the disease. The five-year relative survival rate for stage III and IV disease is 31%, and the five-year relative survival rate for stage I is 95%. Early diagnosis should lower the fatality rate. Unfortunately, early diagnosis is difficult because of the physically inaccessible location of the ovaries, the lack of specific symptoms in early disease, and the limited understanding of ovarian oncogenesis. Screening tests for ovarian cancer need high sensitivity and specificity to be useful because of the low prevalence of undiagnosed ovarian cancer. Because currently available screening tests do not achieve high levels of sensitivity and specificity, screening is not recommended for the general population. The theoretical advantage of screening is much higher for women at high risk (such as those with a strong family history of ovarian cancer and those with BRCA 1 or BRCA 2 mutations). However, even for women at high risk, no prospective studies have shown benefits of screening. The public health challenge is that 90% of ovarian cancer occurs in women who are not in an identifiable high-risk group, and most women are diagnosed with advanced-stage disease. Currently available tests (CA-125, transvaginal ultrasound, or a combination of both) lack the sensitivity and specificity to be useful in screening the general population. Ongoing clinical trials are assessing whether new tumor markers, including those generated by proteomic and genomic studies, will prove useful.

Correlates the Biochemical Markers of Ovarian Neoplasm, Experience From A Tertiary Care Setting in A City Of India.

“…This observation is supported by N.S .Murthy et al1 [4]. Though etiology of ovarian cancer is poorly understood but there are different studies showing urban population and menopausal women are at increased risk of developing malignant ovarian neoplasm.…”

“…Data from various sources reveal that ovarian cancer can shorten the life span by an average of 18 years [4]. The low survival rate is largely attributed to the fact that most cases remain undiagnosed until the disease has progressed to an advanced stage [5].…”

MALDI-MSI and Ovarian Cancer Biomarkers

“…In this context, CA-125 is insufficient as a single biomarker for ovarian cancer diagnosis. The alternative is to identify additional biomarkers, using a proteomic strategy, that can better etablish the diagnosis and prognosis in regards to the tumor stage ( Table 2) [16][17][18][19][20][21][22][23][24] . Presently, two strategies have been established.…”

Proteomic Profiling of Ovarian Cancer Plasma using Immunoaffinity Depleted Plasma and Two-Dimensional PAGE

“…An overall 5-year survival rate of 95% can be achieved, however, if ovarian cancer is detected early. The asymptomatic nature of the disease and the low sensitivity and specificity of the currently available test utilizing CA-125 present a major challenge for achieving early detection [1].…”