Overview

Evidence of Benefit or Lack of Benefit Associated with Screening
        Single-threshold cancer antigen 125 (CA-125) levels and transvaginal ultrasound (TVU)

Note: Separate PDQ summaries on Ovarian Cancer Prevention; Ovarian Epithelial Cancer Treatment; Ovarian Germ Cell Tumor Treatment; and Ovarian Low Malignant Potential Tumor Treatment are also available.

There is solid evidence to indicate that routine screening for ovarian cancer with the serum marker CA-125 and TVU does not result in a decrease in mortality from ovarian cancer.

Magnitude of Effect: No reduction in mortality

• Study Design: Evidence obtained from one randomized controlled trial.
• Internal Validity: Good.
• Consistency: One trial has evaluated the impact on mortality from ovarian cancer.
• External Validity: Good.

Based on solid evidence, routine screening for ovarian cancer results in false-positive test results among 9.6% of those screened; of those with false-positive results who had surgery, the complication rate was 20.6 cases per 100 surgical procedures. There were higher oophorectomy rates among screened women (85.7 per 10,000 person-years) than among usual care women (64.2 per 10,000 person-years). Minor complications with screening such as fainting and bruising occurred at a rate of 58.3 cases per 10,000 women screened with CA-125 and 3.3 cases per 10,000 women screened with TVS. There were more deaths from ovarian cancer in the screened group than in the usual care group, but the difference was not statistically significant.

Magnitude of Effect:

• False-positive rate: 9.6%.
• Minor complications with screening: 58.3 cases per 10,000 women screened with CA-125 and 3.3 cases per 10,000 women screened with TVS.
• Proportion of women with false-positive results who had surgery: 32.9%.
• Surgery complication rate: 20.6 cases per 100 surgical procedures.
• Oophorectomy rates among screened women compared with usual care women: 85.7 versus 64.2 per 10,000 person-years.

• Study Design: Evidence obtained from one randomized controlled trial.
• Internal Validity: Good.
• Consistency: Not applicable (N/A).
• External Validity: Good.