Ovarian Screening Tests Can Be Sensitive and Accurate

Combined blood test and ultrasound gives best results

THURSDAY, Mar. 12 (HealthDay News) -- Ovarian screening tests comprising transvaginal ultrasound and a CA125 blood test have a high degree of sensitivity and specificity, while transvaginal ultrasound alone is also highly sensitive but lacks the specificity of the combined screening test, according to an article published online Mar. 11 in The Lancet Oncology.

Usha Menon, M.D., of University College London in the United Kingdom, and colleagues analyzed data from the U.K. Collaborative Trial of Ovarian Cancer Screening, which enrolled 202,638 postmenopausal women aged 50 to 74 years between 2001 and 2005, of whom 50,640 were randomized to multi-modal screening by blood test and ultrasound, 50,639 were screened by ultrasound alone, and 101,359 were controls.

Multi-modal screening detected 42 primary ovarian and tubal cancers, while 45 were detected in the ultrasound group, the investigators note. For all primary ovarian and tubal cancers, the sensitivity, specificity and positive-predictive values of multi-modal testing was 89.4 percent, 99.8 percent and 43.3 percent, respectively, versus 84.9 percent, 98.2 percent and 5.3 percent, respectively, for ultrasound alone, the researchers found.

"There are inherent differences between the two strategies being tested, with a more subjective element inherent in the ultrasound-based strategy than with the CA125 test, for which it is easy to implement stringent quality control," the authors write. "However, both screening strategies have encouraging performance characteristics."

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