Annual screening with transvaginal ultrasound (TVS) and  CA-125 doesn’t reduce deaths from ovarian cancer, and the harms outweigh the  benefits for asymptomatic women. So says the US Preventive Services Task Force  (USPSTF) in reaffirming a 2004 recommendation, based on a new literature  review.

, the recommendation follows a 2008  literature review by USPSTF and a bridging analysis of data through 2011 from  randomized, controlled trials (RCTs) on ovarian cancer screening. A single RCT  has published mortality results associated with TVS and CA-125, concluding that  use of the diagnostics in combination did not reduce deaths due to ovarian  cancer in asymptomatic women at average risk. Performing such screening, the  USPSTF statement notes, could place this population at risk for major surgery  when they do not have cancer. 

The USPSTF guidelines do not apply to women with known  mutations (such as BRCA1 and BRCA2) that are associated with increased risk of  ovarian cancer. The panel also did not find sufficient evidence of benefit to  warrant annual screening in women with a family history of ovarian cancer,  although the available evidence suggests that the risk:benefit equation is less  certain in these patients.  

Several trials analyzed by USPSTF have shown harms  associated with ovarian cancer screening, including high false-positive and low  positive predictive values for CA-125 combined with TVS, resulting in  oophorectomy. The panel noted that evidence is limited on other types of  screening, such as large-panel biomarker screening, and earlier detection based  on a combination of symptoms and CA-125 or TVS. Results from the ongoing United  Kingdom Collaborative Trials of Ovarian Cancer Screening, USPSTF hopes, will  shed light on the value of an algorithm-based approach to diagnosis.

Annual screening with transvaginal ultrasound (TVS) and CA-125 doesnâ€™t reduce deaths from ovarian cancer, and the harms outweigh the benefits for asymptomatic women. So says the US Preventive Services Task Force (USPSTF) in reaffirming a 2004 recommendation, based on a new literature review.