July 2010 · Vol. 22, No. 07UPDATE: OVARIAN CANCER
Recent studies shed light on early detection of ovarian cancer—but it’s not a green light for routine screening. Until promising avenues of research lead further, refer women who have an adnexal mass, an elevated CA-125 level, and troubling ultrasonographic findings to a specialist—early.
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Fast Track
Screening for ovarian cancer in the general population using annual CA-125 testing and TVU is not yet recommended
Multimodal screening for ovarian cancer has higher specificity and positive predictive value than transvaginal ultrasonography alone
86.8% of women who had both an adnexal mass and a serum CA-125 level of 60–120 U/mL were found to have ovarian cancer
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David
G.
Mutch,
MD
Dr. Mutch is Judith and Ira C. Gall Professor and Director of the Division of Gynecologic Oncology at Washington University in St. Louis. 
Nora
Kizer,
MDDr. Kizer is a Fellow in the Division of Gynecologic Oncology at Washington University in St. Louis.
Dr. Mutch reports that he has received grant or research support from Lilly and Genentech. He serves as a speaker for GSK, Lilly, and Merck. Dr. Kizer reports no financial relationships relevant to this article.
Because ovarian cancer is usually diagnosed at an advanced stage—when prognosis is much worse than earlier in its course—a great deal of effort has been directed toward developing strategies to detect it early. These strategies include screening by a woman’s primary gynecologist with 1) a test of the serum CA-125 level and 2) transvaginal ultrasonography (TVU).
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