Prevalence screening for ovarian cancer in postmenopausal women by CA 125 measurement and ultrasonography

This is the authors' abstract. We don't add key points for this paper.

Objective-To assess the performance of the sequential combination of serum CA 125 measure- ment and ultrasonography in screening for ovarian cancer.Design-The serum CA 125 concentration of each subject was determined and those with a concentra- tion : 30 U/ml were recalled for abdominal ultra- sonography.If ultrasonography gave abnormal results surgical investigation was arranged.Volunteers were followed up by annual postal questionnaire. Setting-General practice, occupational health departments, ovarian cancer screening clinic.Subjects-22 000 women volunteers who were postmenopausal and aged over 45 years.Main outcome measures-Apparent sensitivity, specificity, positive predictive value, years of cancer detected.Results-41 women had a positive screening result and were investigated surgically.11 had ovarian cancer (true positive result) and 30 had other dis- orders or no abnormality (false positive result).Of the 21959 volunteers with a negative screening result, eight subsequently presented clinically with ovarian cancer (false negative result) and 21951 had not developed ovarian cancer during follow up (apparent true negative result).The screening protocol achieved a specificity of 99.9%, a positive predictive value of 26.8%, and an apparent sensi- tivity of 78.6% and 57.9% at one year and two year follow up respectively.The estimated number of years of cancer detected by the prevalence screen was 14 years.Conclusions-This screening protocol is highly specific for ovarian cancer and can detect a substan- tial proportion ofcases at a preclinical stage.Further investigation is required to determine the effect of the screening protocol on the ratio of early to late stage disease detected and on mortality from ovarian cancer.