Screening for ovarian cancer.

Whilst the majority of patients with ovarian cancer present with advanced stage disease and have a poor prognosis, the outlook for women with stage I disease is relatively good. An effective screening test for early stage ovarian cancer may therefore result in a significant improvement in ovarian cancer statistics. Extremely high specificity is an essential requirement of any potential screening test in view of the need for surgical investigation of women with a positive test result. No single test has yet demonstrated sufficient specificity when used alone to screen apparently healthy postmenopausal women. A multimodal approach incorporating serum CA-125 measurement, pelvic examination and real time ultrasonography has achieved high levels of specificity. The sensitivity of this screening programme for early stage ovarian cancer is currently under investigation.