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Ovarian cancer screening does not reduce mortality rates

Ovarian cancer screening – using both ultrasound and antigen testing - does not reduce the risk of mortality and significantly increases a woman's risk of undergoing an invasive medical procedure including oophorectomy, say US researchers.

They studied 80,000 women aged 55 to 74 who underwent annual screening with transvaginal ultrasound and serum cancer  antigen 125 (CA-125). After 13 years follow up there were 118 deaths from ovarian cancer in the intervention group and 100 among those receiving usual care.

Of 3,285 women with false positive results, 1,080 underwent surgery, a third of them having one or both ovaries removed. 222 of those undergoing surgery developed major complications. Oophorectomy rates were higher in the intervention group.

Ovarian cancer is a leading cause of death in women, with a five-year survival rate of 30%.

'More ovarian cancers were diagnosed in the screened group than in the usual care group, suggesting that some of the additional cancers detected by screenings were not clinically important, and if left undetected, may have never caused any symptoms or affected the women during their lifetimes,' said study leader Professor Saundra Buys, professor of internal medicine at the University of Utah Health Sciences Center.

In the UK CA-125 is currently used to monitor treatment for ovarian cancer and is being studied as a possible screening tool.

JAMA. 2011;305[22]2295-2303

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