Screening for ovarian cancer.

Ovarian cancer frequently presents late, when chances for long-term survival are poor. The increased survival advantage for patients diagnosed with early-stage ovarian cancer suggests that screening to detect early-stage disease might have an impact on disease mortality. Attempts are being made to develop effective screening procedures for early ovarian cancer in symptom-free women, using a variety of serum tumor markers, proteomic patterns, and ovarian morphological and vascular features. Two distinct screening strategies have emerged, one utilizing transvaginal scanning as the primary test, and the other involving measurement of the serum tumor marker CA125 as the primary test with transvaginal ultrasonography as the secondary test (multimodal screening). Large randomized trials are now underway to provide definitive data on the impact of screening on mortality and address morbidity, health economics and psychosocial issues.