By mathematically modeling the behavior of ovarian cancers in hypothetical populations of BRCA mutation carriers and average-risk patients, researchers have gained insight into their natural history and have investigated a potential role for screening [3,4]. Based on their findings, current screening tools are expected to have low effectiveness because of the tendency for small cancers to spread rapidly [3,4]. Brown and Palmer [3], when Reprint requests to: publications@acr.org Ovarian Cancer Screening modeling serous cancers in high-risk patients, projected that an annual screening tool for ovarian cancer would need to detect tumors as small as 0.5 cm in diameter in order to achieve a 50% mortality reduction. After evaluating the current literature on this topic, there is no clear evidence to support screening women of average risk (no personal history, no family history, no known or suspected genetic predisposition, and no elevated CA-125). However, this document provides an update on areas of investigation that may support a future role for imaging and serum biomarkers in special cases. Overview of Imaging Modalities Most of the peer-reviewed imaging literature on ovarian cancer screening to date has evaluated the use of pelvic ultrasound (US), as it is generally considered the first-line imaging modality for evaluation of the adnexa. US is particularly attractive as a potential screening modality as it is inexpensive and does not expose patients to ionizing radiation. Other cross-sectional imaging methods, including magnetic resonance imaging (MRI), fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), computed tomography (CT), and FDG-PET/CT, have no known or foreseeable role in screening. Attention has also been directed to the role of CA-125 (a widely known serum tumor biomarker) for screening, either alone or in combination with imaging (eg, US and CA-125).
Ovarian Cancer Screening. By mathematically modeling the behavior of ovarian cancers in hypothetical populations of BRCA mutation carriers and average-risk patients, researchers have gained insight into their natural history and have investigated a potential role for screening [3,4]. Based on their findings, current screening tools are expected to have low effectiveness because of the tendency for small cancers to spread rapidly [3,4]. Brown and Palmer [3], when Reprint requests to: publications@acr.org Ovarian Cancer Screening modeling serous cancers in high-risk patients, projected that an annual screening tool for ovarian cancer would need to detect tumors as small as 0.5 cm in diameter in order to achieve a 50% mortality reduction. After evaluating the current literature on this topic, there is no clear evidence to support screening women of average risk (no personal history, no family history, no known or suspected genetic predisposition, and no elevated CA-125). However, this document provides an update on areas of investigation that may support a future role for imaging and serum biomarkers in special cases. Overview of Imaging Modalities Most of the peer-reviewed imaging literature on ovarian cancer screening to date has evaluated the use of pelvic ultrasound (US), as it is generally considered the first-line imaging modality for evaluation of the adnexa. US is particularly attractive as a potential screening modality as it is inexpensive and does not expose patients to ionizing radiation. Other cross-sectional imaging methods, including magnetic resonance imaging (MRI), fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), computed tomography (CT), and FDG-PET/CT, have no known or foreseeable role in screening. Attention has also been directed to the role of CA-125 (a widely known serum tumor biomarker) for screening, either alone or in combination with imaging (eg, US and CA-125).