Ten Important Considerations for Ovarian Cancer Screening

Abstract

The unique intricacies of ovarian cancer screening and perspectives of different screening methods are presented as ten considerations that are examined. Included in these considerations are: (1) Deciding on the number of individuals to be screened; (2) Anticipating screening group reductions due to death; (3) Deciding on the duration and frequency of screening; (4) Deciding on an appropriate follow-up period after screening; (5) Deciding on time to surgery when malignancy is suspected; (6) Deciding on how screen-detected ovarian cancers are treated and by whom; (7) Deciding on how to treat the data of enrolled participants; (8) Deciding on the most appropriate way to assign disease-specific death; (9) Deciding how to avoid biases caused by enrollments that attract participants with late-stage disease who are either symptomatic or disposed by factors that are genetic, environmental or social; and (10) Deciding whether the screening tool or a screening process is being tested. These considerations are presented in depth along with illustrations of how they impact the outcomes of ovarian cancer screening. The considerations presented provide alternative explanations of effects that have an important bearing on interpreting ovarian screening outcomes.

Diagnosis of epithelial ovarian cancer using a combined protein biomarker panel

“…The following analysis presents a screening tool based on the dysregulation of CA125 (uniprot: Q8WXI7) and the previously described Vitamin K-dependent protein Z (PROZ, uniprot: P22891), phosphatidylcholine-sterol acyltransferase (LCAT, uniprot: P04180) and C-reactive protein (CRP, uniprot: P02741) against a pre-disease baseline established for each individual patient. We demonstrate the tool’s utility in a simulated annual screening programme providing the basis to consider, 13 with the addition of further validation studies, how this may translate to a screening programme.…”

The Diagnostic Accuracy of Human Epididymis Factor 4 for the Prediction of Optimal Debulking in Patients With Ovarian Cancer: A Meta-Analysis of Observational Studies

“…4 Suboptimal debulking surgery is related to poor prognosis, and the decision to perform primary versus secondary debulking relies on the extent of the disease and the surgeon's experience. 4,5 During the last decades, new screening and monitoring tools have been discovered in the field of ovarian cancer. 4,6 Human epididymis factor-4 (HE4) is a whey acid protein that is localized on human chromosome 20q12-13.1.…”

Ovarian Cancer Screening: Lessons about Effectiveness

“…These considerations are presented in depth along with illustrations of how they impact the outcomes of ovarian cancer screening trials. These considerations highlight effects that have an important bearing on ovarian screening outcomes and their interpretations [ 10 ].…”