Abstract
Background
Ovarian carcinoma is a poor prognosis cancer mainly due to its late diagnosis. Its incidence is relatively low but mortality is high. The symptomatology is only slightly specific, which complicates diagnostic management. It would therefore be interesting to be able to establish a diagnosis as early as possible in order to improve the prognosis of patients suffering from ovarian cancer.
Materials and methods
Currently, the combination of an ultrasound examination with a cancer antigen (CA)-125 assay is the most effective diagnostic technique, but not already admitted as a screening method. Therefore, we realized an exhaustive analysis of the most important studies in the last 15 years, in order to find new approaches in ovarian cancer screening.
Results
The age for initiating screening and its frequency are issues that are not fully resolved. The false positives and morbidity that result from screening are currently notable limitations.
Conclusions
The latest data do not support effective screening in the general population.
Author statement
Research funding: None declared.
Conflict of interest: None declared.
Informed consent: None.
Ethical approval: None.
References
[1] Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. Cancer J Clin. 2009;59:225–49.10.3322/caac.20006Search in Google Scholar
[2] Schorge JO, Modesitt SC, Coleman RL, Cohn DE, Kauff ND, Duska LR, et al. SGO white paper on ovarian cancer: etiology, screening and surveillance. Gynecol Oncol. 2010;119:7–17.10.1016/j.ygyno.2010.06.003Search in Google Scholar
[3] Clarke-Pearson DL. Clinical practice. Screening for ovarian cancer. N Engl J Med. 2009;361:170–7.10.1056/NEJMcp0901926Search in Google Scholar
[4] Pearce CL, Templeman C, Rossing MA. Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies. Lancet Oncol. 2012;13:385–94.10.1016/S1470-2045(11)70404-1Search in Google Scholar
[5] Crum CP. Intercepting pelvic cancer in the distal fallopian tube: theories or realities. Mol Oncol. 2009;3:165–70.10.1016/j.molonc.2009.01.004Search in Google Scholar PubMed PubMed Central
[6] Kindelberger DW, Lee Y, Miron A, Hirsch MS, Feltmate C, Medeiros F, et al. Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: evidence for a causal relationship. Am J Surg Pathol. 2007;31:161–9.10.1097/01.pas.0000213335.40358.47Search in Google Scholar PubMed
[7] Whittemore AS, Harris R, Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. Invasive epithelial ovarian cancers in white women. Collaborative Cancer Group. Am J Epidemiol. 1992;136:1184–203.10.1093/oxfordjournals.aje.a116427Search in Google Scholar PubMed
[8] US Cancer Statistics Working Group. United States Cancer Statistics (USCS): 1999–2014 cancer incidence and mortality data. https://nccd.cdc.gov/uscs/. 2017. Accessed December 19, 2017.Search in Google Scholar
[9] Swiss Cancer league Statistics. 2011–2015. National Institute for Cancer Epidemiology and Registration NICER. https://www.nicer.org. December 2018.Search in Google Scholar
[10] National Institut. France. Projected incidence and mortality in 2017 of ovarian cancer in women in France. http://lesdonnees.e-cancer.fr.Search in Google Scholar
[11] Goff B. Symptoms associated with ovarian cancer. Clin Obstet Gynecol. 2012;55:36–42.10.1097/GRF.0b013e3182480523Search in Google Scholar PubMed
[12] National Academies of Sciences, Engineering and Medicine. Ovarian cancers: evolving paradigms in research and care. Washington, DC: National Academies Press; 2016.Search in Google Scholar
[13] Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. J Am Med Assoc. 2004;291:2705–12.10.1001/jama.291.22.2705Search in Google Scholar PubMed
[14] Goff BA, Mandel LS, Drescher CW, Urban N, Gough S, Schurman KM, et al. Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer. 2007;109:221–7.10.1002/cncr.22371Search in Google Scholar PubMed
[15] Ebell MH, Culp MB, Radke TJ. A systematic review of symptoms for the diagnosis of ovarian cancer. Am J Prev Med. 2016;50:384–94.10.1016/j.amepre.2015.09.023Search in Google Scholar
[16] Manegold-Brauer G, Bellin AK, Tercanli S, Lapaire O, Heinzelmann-Schwarz V. The special role of ultrasound for screening, staging and surveillance of malignant ovarian tumors: distinction from other methods of diagnostic imaging. Arch Gynecol Obstet. 2014;289:491–8.10.1007/s00404-013-3081-8Search in Google Scholar
[17] Nguyen L, Cardenas-Goicoechea SJ, Gordon P, Curtin C, Momeni M, Chuang L, et al. Biomarkers for early detection of ovarian cancer. Womens Health 2013;9:171–87.10.2217/WHE.13.2Search in Google Scholar
[18] Menon U, Gentry-Maharaj A, Hallett R, Ryan A, Burnell M, Sharma A, et al. Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Lancet Oncol. 2009;10:327–40.10.1016/S1470-2045(09)70026-9Search in Google Scholar
[19] Stormo AR, Cooper CP, Hawkins NA, Saraiya M. Physician characteristics and beliefs associated with use of pelvic examinations in asymptomatic women. Prev Med. 2012;54:415–21.10.1016/j.ypmed.2012.03.012Search in Google Scholar PubMed
[20] Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD. Clinical Guidelines Committee of the American College of Physicians. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161:67–72.10.7326/M14-0701Search in Google Scholar PubMed
[21] American College of Obstetricians and Gynecologists (ACOG). The role of the obstetrician–gynecologist in the early detection of epithelial ovarian cancer. Committee Opinion No. 477. Obstet Gynecol. 2011;117:742–6.10.1097/AOG.0b013e31821477dbSearch in Google Scholar PubMed
[22] Moyer VA. U.S. Preventive Services Task Force. Screening for ovarian cancer: US Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2012;157:900–4.10.7326/0003-4819-157-11-201212040-00539Search in Google Scholar PubMed
[23] Screening for Ovarian Cancer. US Preventive Services Task Force USPSTF Recommendation Statement. J Am Med Assoc. 2018;319: 588– 594.10.1001/jama.2017.21926Search in Google Scholar PubMed
[24] Jacobs IJ, Menon U, Ryan A, Gentry-Maharaj A, Burnell M, Kalsi JK, et al. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet. 2016;387:945–56.10.1158/1538-7445.AM2016-CT104Search in Google Scholar
[25] Jacobs IJ, Skates SJ, MacDonald N, Menon U, Rosenthal AN, Davies AP, et al. Screening for ovarian cancer: a pilot randomized controlled trial. Lancet. 1999;353:1207–10.10.1016/S0140-6736(98)10261-1Search in Google Scholar
[26] Pinsky PF, Yu K, Kramer BS, Black A, Buys SS, Partridge E, et al. Extended mortality results for ovarian cancer screening in the PLCO trial with median 15 years follow-up. Gynecol Oncol. 2016;143:270–5.10.1016/j.ygyno.2016.08.334Search in Google Scholar PubMed PubMed Central
[27] Prat J. FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014;124:1–5.10.1016/j.ijgo.2013.10.001Search in Google Scholar PubMed
[28] Barrett J, Jenkins V, Farewell V, Menon U, Jacobs I, Kilkerr J, et al. Psychological morbidity associated with ovarian cancer screening: results from more than 23,000 women in the randomised trial of ovarian cancer screening (UKCTOCS). BJOG. 2014;121:1071–9.10.1111/1471-0528.12870Search in Google Scholar PubMed
[29] Andersen MR, Drescher CW, Zheng Y, Bowen DJ, Wilson S, Young A, et al. Changes in cancer worry associated with participation in ovarian cancer screening. Psycho-oncology. 2007;16:814–20.10.1002/pon.1151Search in Google Scholar PubMed
[30] Narod SA. Is there a future for ovarian cancer screening? JAMA Intern Med. 2018;178:611–2.10.1001/jamainternmed.2018.0591Search in Google Scholar PubMed
[31] Gewandter JS, Smith SM, McKeown A, Burke LB, Hertz SH, Hunsinger M, et al. Reporting of primary analyses and multiplicity adjustment in recent analgesic clinical trials: ACTTION systematic review and recommendations. Pain. 2014;155:461–6.10.1016/j.pain.2013.11.009Search in Google Scholar PubMed
[32] Skates SJ, Greene MH, Buys SS, Mai PL, Brown P, Piedmonte M, et al. Early detection of ovarian cancer using the risk of ovarian cancer algorithm with frequent CA125 testing in women at increased familial risk – combined results from two screening trials. Clin Cancer Res. 2017;23:3628–37.10.1158/1078-0432.CCR-15-2750Search in Google Scholar PubMed PubMed Central
[33] Anderson CK, Wallace S, Guiahi M, Sheeder J, Behbakht K, Spillman MA. Risk-reducing salpingectomy as preventative strategy for pelvic serous cancer. Int J Gynecol Cancer. 2013;23:417–21.10.1097/IGC.0b013e3182849dbaSearch in Google Scholar PubMed
[34] Kwon JS, Tinker A, Pansegrau G, McAlpine J, Housty M, McCullum M, et al. Prophylactic salpingectomy and delayed oophorectomy as an alternative for BRCA mutation carriers. Obstet Gynecol. 2013;121:14–24.10.1097/AOG.0b013e3182783c2fSearch in Google Scholar
[35] Long Roche KC, Abu-Rustum NR, Nourmoussavi M, Zivanovic O. Risk-reducing salpingectomy: let us be opportunistic. Cancer. 2017;123:1714–20.10.1002/cncr.30528Search in Google Scholar PubMed PubMed Central
[36] Opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention. ACOG Committee Opinion No. 774. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;133:e279–84.10.1097/AOG.0000000000003164Search in Google Scholar PubMed
[37] Gorelik E, Landsittel DP, Marrangoni AM, Modugno F, Velikokhatnaya L, Winans MT, et al. Multiplexed immunobead-based cytokine profiling for early detection of ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2005;14:981–7.10.1158/1055-9965.EPI-04-0404Search in Google Scholar PubMed
[38] Lokshin AE, Winans M, Landsittel D, Marrangoni AM, Velikokhatnaya L, Modugno F, et al. Circulating IL-8 and anti-IL-8 autoantibody in patients with ovarian cancer. Gynecol Oncol. 2006;102:244–51.10.1016/j.ygyno.2005.12.011Search in Google Scholar PubMed
[39] Zhang Z, Yu Y, Xu F, Berchuck A, van Haaften-Day C, Havrilesky LJ, et al. Combining multiple serum tumor markers improves detection of stage I epithelial ovarian cancer. Gynecol Oncol. 2007;107:526–31.10.1016/j.ygyno.2007.08.009Search in Google Scholar PubMed PubMed Central
[40] Yurkovetsky Z, Skates S, Lomakin A, Nolen B, Pulsipher T, Modugno F, et al. Development of a multimarker assay for early detection of ovarian cancer. J. Clin. Oncol. 2010;28:2159–66.10.1200/JCO.2008.19.2484Search in Google Scholar PubMed PubMed Central
[41] Fung ET. A recipe for proteomics diagnostic test development: the OVA1 test, from biomarker discovery to FDA clearance. Clin Chem. 2010;56:327–9.10.1373/clinchem.2009.140855Search in Google Scholar PubMed
[42] Kritsch D, Hoffmann F, Steinbach D, Jansen L, Mary Photini S, Gajda M, et al. Tribbles 2 mediates cisplatin sensitivity and DNA damage response in epithelial ovarian cancer. Int J Cancer. 2017;141:1600–13.10.1002/ijc.30860Search in Google Scholar PubMed
[43] Kinde I, Bettegowda C, Wang Y, Wu J, Agrawal N, Shih IeM, et al. Evaluation of DNA from the Papanicolaou test to detect ovarian and endometrial cancers. Sci Transl Med. 2013;5:167ra4.10.1126/scitranslmed.3004952Search in Google Scholar PubMed PubMed Central
[44] Moss HA, Berchuck A, Neely ML, Myers ER, Havrilesky LJ. Estimating cost-effectiveness of a multimodal ovarian cancer. Screening program in the United States. secondary analysis of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). JAMA Oncol. 2018;4:190–5.10.1001/jamaoncol.2017.4211Search in Google Scholar PubMed PubMed Central
© 2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Special Section: "Update in the management of ovarian cancer"; Guest Editors: René Druckmann and Adolf E. Schindler
- Editorial
- Preface to special issue: update in the management of ovarian cancer
- Original Article
- Ovarian cancer screening in the general population
- Review Articles
- Non-surgical prevention strategies in women with hereditary breast and ovarian cancer syndromes
- Hyperthermic intraperitoneal chemotherapy in ovarian cancer: an update
- Genetic testing in ovarian cancer – clinical impact and current practices
- The place of secondary complete cytoreductive surgery in advanced ovarian cancer
- An update on preoperative assessment of the resectability of advanced ovarian cancer
- Impact of retroperitoneal lymph node dissection in ovarian cancer – time for paradigm shift?
- Minireviews
- Ultrasound screening of ovarian cancer
- How to manage BRCA mutation carriers?
- Regular Issue
- Original Articles
- Progestogen addition with low-dose levonorgestrel intrauterine system in menopausal hormone treatment gives less normal breast tissue proliferation than oral norethisterone acetate or medroxyprogesterone acetate
- The effectiveness of military physical exercise on irisin concentrations and oxidative stress among male healthy volunteers
- Periodontal status and bone metabolism in women in reproductive and postmenopausal periods
- Modulatory effect of tropisetron in the liver of streptozotocin-induced diabetes in rats: biochemical and histological evidence
- Celecoxib versus mefenamic acid in the treatment of primary dysmenorrhea
- The predictive role of amylase and lipase levels on pancreas injury diagnosis in patients with blunt abdominal trauma
- Case Report
- Low hormone levels during an attack of systemic capillary leak syndrome normalizing after treatment
Articles in the same Issue
- Special Section: "Update in the management of ovarian cancer"; Guest Editors: René Druckmann and Adolf E. Schindler
- Editorial
- Preface to special issue: update in the management of ovarian cancer
- Original Article
- Ovarian cancer screening in the general population
- Review Articles
- Non-surgical prevention strategies in women with hereditary breast and ovarian cancer syndromes
- Hyperthermic intraperitoneal chemotherapy in ovarian cancer: an update
- Genetic testing in ovarian cancer – clinical impact and current practices
- The place of secondary complete cytoreductive surgery in advanced ovarian cancer
- An update on preoperative assessment of the resectability of advanced ovarian cancer
- Impact of retroperitoneal lymph node dissection in ovarian cancer – time for paradigm shift?
- Minireviews
- Ultrasound screening of ovarian cancer
- How to manage BRCA mutation carriers?
- Regular Issue
- Original Articles
- Progestogen addition with low-dose levonorgestrel intrauterine system in menopausal hormone treatment gives less normal breast tissue proliferation than oral norethisterone acetate or medroxyprogesterone acetate
- The effectiveness of military physical exercise on irisin concentrations and oxidative stress among male healthy volunteers
- Periodontal status and bone metabolism in women in reproductive and postmenopausal periods
- Modulatory effect of tropisetron in the liver of streptozotocin-induced diabetes in rats: biochemical and histological evidence
- Celecoxib versus mefenamic acid in the treatment of primary dysmenorrhea
- The predictive role of amylase and lipase levels on pancreas injury diagnosis in patients with blunt abdominal trauma
- Case Report
- Low hormone levels during an attack of systemic capillary leak syndrome normalizing after treatment