Marchetti Claudia, De Felice Francesca, Perniola Giorgia, Lecce Francesca, Vertechy Laura, Monti Marco, Musio Daniela, Muzii Ludovico, Tombolini Vincenzo, Benedetti Panici Pierluigi
Department of Gynecological and Obstetrical Sciences and Urological Sciences, "Sapienza" University of Rome, Rome, Italy.
Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy.
Curr Probl Cancer. 2018 Mar-Apr;42(2):235-240. doi: 10.1016/j.currproblcancer.2017.12.005. Epub 2018 Jan 5.
Treatment of ovarian cancer (OC) is a challenge and its poor prognosis still remains a problem of major importance. Due to the lack of early and specific symptoms, the vast majority of women are diagnosed with an advanced stage disease. The aim of this meta-analysis is to evaluate the impact of OC screening program in asymptomatic women on clinical outcomes.
A systematic literature electronic search was conducted in Pubmed, Medline, Scopus, and ClinicalTrials.gov databases. Articles were selected with a systematic approach. Clinical trials concerning screening strategy compared with usual care in asymptomatic OC women were considered, without any restrictions on the publication date. Trials were eligible if participants were asymptomatic and postmenopausal women. Outcomes included OC diagnosis and disease specific mortality. The pooled relative risk (RR) was calculated using a fixed-effects model.
Overall, 3 randomized controlled trials met inclusion criteria, totaling 353,590 asymptomatic women. In total 177,188 women were assigned to screening program, and 176,402 women were assigned to usual care. The risk of OC diagnosis, both overall and at an early stage, was higher in screening group (RR = 1.07, 95% CI: 0.98-1.18; and RR = 1.30, 95% CI: 1.14-1.49, respectively). The RR for disease specific mortality was 0.96 (95% CI: 0.85-1.10).
Our results suggest the possible benefit of OC screening program in term of early stage diagnosis and reduced specific OC mortality. Further studies of environmental or constitutional factors may lead to the identification of patient populations that could benefit from a screening program.
卵巢癌（OC）的治疗是一项挑战，其预后较差仍然是一个至关重要的问题。由于缺乏早期和特异性症状，绝大多数女性被诊断为晚期疾病。本荟萃分析的目的是评估无症状女性的OC筛查计划对临床结局的影响。
在PubMed、Medline、Scopus和ClinicalTrials.gov数据库中进行了系统的文献电子检索。采用系统方法选择文章。考虑了关于筛查策略与无症状OC女性常规护理相比的临床试验，对发表日期没有任何限制。如果参与者是无症状的绝经后女性，则试验符合条件。结局包括OC诊断和疾病特异性死亡率。使用固定效应模型计算合并相对风险（RR）。
总体而言，3项随机对照试验符合纳入标准，共有353,590名无症状女性。总共有177,188名女性被分配到筛查计划，176,402名女性被分配到常规护理。筛查组的OC总体诊断风险和早期诊断风险均较高（RR分别为1.07，95%CI：0.98 - 1.18；RR为1.30，95%CI：1.14 - 1.49）。疾病特异性死亡率的RR为0.96（95%CI：0.85 - 1.10）。
我们的结果表明，OC筛查计划在早期诊断和降低OC特异性死亡率方面可能有益。对环境或体质因素的进一步研究可能会确定哪些患者群体可以从筛查计划中获益。
