Annual screening does not reduce ovarian cancer deaths

Compared with no regular screening, early screening doesn’t catch ovarian cancer earlier or prevent more women from dying of the disease, according to a large, randomized, controlled, multicenter trial, part of the larger Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

The study was presented at the annual meeting of the American Society of Clinical Oncology in Chicago (June 4-8) and published in the Journal of the American Medical Association (2011;305[22]:2295-2303).

Researchers assigned 78,216 women, 55 to 74 years of age, to undergo either annual screening for ovarian cancer with CA-125 blood testing and transvaginal ultrasound or usual care with no screening between 1993 and 2001. The women were followed for cancer diagnoses and death until 2010-a median of 12.4 years (maximum, 13 years). In the screening group, 212 woman were diagnosed with ovarian cancer and 118 died compared with 176 diagnoses and 100 deaths in the unscreened group. In both groups, more than 75% of women diagnosed with cancer had stage 3 or 4 disease.

“We conclude that annual screening for ovarian cancer as performed in the PLCO trial with simultaneous CA-125 and transvaginal ultrasound does not reduce disease-specific mortality in women at average risk of ovarian cancer but does increase invasive medical procedures and associated harms,” the authors write.

More than 3,000 women in the screening group had false-positive results, and 1,000 of them underwent surgery to remove an ovary. Surgery led to serious infection or cardiovascular and other complications in 163 women.