Ovarian cancer screening

Hematol Oncol Clin North Am. 2003 Aug;17(4):989-1005, ix. doi: 10.1016/s0889-8588(03)00063-7.


In an ongoing effort to design an efficacious, cost-effective ovarian cancer screening method, the existing tests, CA 125 and transvaginal sonography, are being optimized and combined in a multimodal strategy, and new promising serum markers, such as mesothelin and HE4, are being developed and evaluated. Detection has been found to improve when multiple serum markers are used in a longitudinal logarithm. The parametric empirical Bayes approach improves screening algorithms by capturing the stability of markers over time in a heterogeneous population. It also has relatively simple extensions to multiple markers. The evaluation of markers increasingly accounts for characteristics of a woman that may affect her marker levels and accounts for the cancer's characteristics, histology, and grade. Receiver operating characteristic curves are helpful for evaluation because they relate a marker's sensitivity to the specificity at which it operates. Large, well-designed randomized controlled trials are under way to gauge the performance of existing screening methods.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antigens, Tumor-Associated, Carbohydrate / blood
  • Biomarkers, Tumor / blood*
  • CA-125 Antigen / blood
  • Disease-Free Survival
  • Female
  • Glycoproteins
  • Humans
  • Macrophage Colony-Stimulating Factor / blood
  • Mass Screening*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / mortality
  • Proteins
  • Sensitivity and Specificity


  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • CA-125 Antigen
  • Glycoproteins
  • OVX1 antigen
  • Proteins
  • Macrophage Colony-Stimulating Factor