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May 2018

Is There a Future for Ovarian Cancer Screening?

Author Affiliations
  • 1Women’s College Hospital Research Institute, Toronto, Ontario, Canada
JAMA Intern Med. 2018;178(5):611-612. doi:10.1001/jamainternmed.2018.0591

Currently, about 65% of the 22 000 women diagnosed with ovarian cancer annually in the United States will die of their cancer, and we all would like to reduce the mortality rate.1 Possible approaches to reducing mortality include prevention, screening, and better treatment.2 In the current issue of JAMA, the US Preventive Services Task Force issued a grade D recommendation, against population-based screening for ovarian cancer, based on a review of 4 randomized screening trials.3,4 The 2 largest studies in the review were the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)5 and the Prostate, Lung, Colorectal and Ovarian screening trial (PLCO)6; UKCTOCS used a proprietary algorithm that incorporates changes in cancer antigen 125 (CA-125) over time, whereas the smaller PLCO trial assigned women to CA-125 and ultrasonography vs usual care. Both screening interventions failed to reduce ovarian cancer mortality.3,5,6

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