Screening Postmenopausal Women for Ovarian Cancer: A Systematic Review Article

Fung Kee Fung, M, Bryson, P, Johnston, M et al. (2004). Screening Postmenopausal Women for Ovarian Cancer: A Systematic Review . 26(8), 717-728. 10.1016/S1701-2163(16)30643-0

cited authors

  • Fung Kee Fung, M; Bryson, P; Johnston, M; Charnbers, A; Briere, C; Carey, M; Covens, A; Dal Bello, D; Daya, D; DePetrillo, D; Dodge, J; Eisenhauer, E; Elit, L; Fyles, A; Harrington, W; Hirte, H; Kwon, J; Lukka, H; Rosen, B; Thomas, G; Verma, S; Yoshida, S

authors

abstract

  • Objectives: To assess ovarian cancer screening in asymptomatic, general-risk postmenopausal women. Outcomes of interest were the screening tests assessed (predictive values, sensitivity, and specificity), the stage of screen-detected disease at diagnosis, psychological effects of screening, and survival.Methods: MEDLINE, CANCERLIT, and the Cochrane Library databases were searched to June 2003 using the terms "ovarian," "cancer," "neoplasms," "screening," "clinical trial," "metaanalysis," and "systematic review." Studies were included if they were clinical trials, meta-analyses, or systematic reviews that evaluated tests used to detect ovarian cancer in asymptomatic women in the general population. Studies investigating women at increased risk for ovarian cancer (e.g., family history) and those with symptoms suggestive of ovarian cancer were excluded.Tabulation, Integration, and Results: Seventeen prospective cohort studies and 3 pilot randomized controlled trials were included in this review. Screening tests for cancer antigen 125 (CAI25) and ultrasound had low positive predictive values, resulting in healthy women being recalled and a false-positive rate of 0.01% to 5.8%. Of every 10 000 women participating in an annual screening program with CAI25 for 3 years, 800 will have an ultrasound scan because of an elevated CAI25, 30 will undergo surgery because of an abnormal ultrasound, and 6 will have ovarian cancer detected at surgery (3 will be diagnosed at early-stage disease and have a chance of a cure).Conclusion: There is insufficient evidence to support the introduction of screening for ovarian cancer in the asymptomatic general-risk postmenopausal population. Screening is associated with increased rates of surgery and patient anxiety.

publication date

  • January 1, 2004

Digital Object Identifier (DOI)

start page

  • 717

end page

  • 728

volume

  • 26

issue

  • 8