Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review

This systematic review aimed to investigate the benefits and harms of ovarian cancer screening among average-risk women in the United States. All randomised controlled trials of ovarian cancer screening that reported mortality or quality of life (QOL) outcomes were included. The screening interventions included transvaginal ultrasound, cancer antigen 125 (CA-124) or both. Four trials were included, of which 3 assessed ovarian cancer mortality and one reported on QOL outcomes. No trial found a significant difference in ovarian cancer mortality with screening. Within the two largest trials, screening led to surgery for suspected ovarian cancer in 1% of women without cancer without cancer for CA-125 and in 3% for transvaginal ultrasound with or without CA-125 screening. Major complications occurred in 3% to 15% of surgeries. Evidence on psychological harms was limited but non-significant except in the case of repeat follow-up scans and tests, which increased the risk of psychological morbidity. Given that ovarian cancer mortality did not significantly differ between the two groups, and screening harms included surgery with major surgical complication in women found not to have cancer, further research is required to identify effective approaches for reducing ovarian cancer mortality. The results of this review aligned with the current RACGP guidelines on ovarian cancer screening in Australia. Read the full article