Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115, USA
Cold Spring Harb Perspect Med. 2023 Nov 1;13(11):a041337. doi: 10.1101/cshperspect.a041337.
The risk of death from ovarian cancer is highly associated with the clinical stage at diagnosis. Efforts to implement screening for ovarian cancer have been largely unsuccessful, due to the low prevalence of the disease in the general population and the heterogeneity of the various cancer types that fall under the ovarian cancer designation. A practical test for early detection will require both high sensitivity and high specificity to balance reducing the number of cancer deaths with minimizing surgical interventions for false positive screens. The technology must be cost-effective to deliver at scale, widely accessible, and relatively noninvasive. Most importantly, a successful early detection test must be effective not only at diagnosing ovarian cancer but also in reducing ovarian cancer deaths. Stepwise or multimodal approaches among the various areas under investigation will likely be required to make early detection a reality.
卵巢癌死亡风险与诊断时的临床分期高度相关。由于卵巢癌在普通人群中的发病率较低，以及属于卵巢癌范畴的各种癌症类型存在异质性，因此，实施卵巢癌筛查的努力在很大程度上并未成功。用于早期检测的实用测试需要同时具有高灵敏度和高特异性，以平衡减少癌症死亡人数与减少假阳性筛查的手术干预。该技术必须具有成本效益，能够大规模推广，广泛普及，并且相对无创。最重要的是，成功的早期检测测试不仅要能有效诊断卵巢癌，还要能降低卵巢癌死亡率。在各个研究领域中采用逐步或多模式的方法可能是实现早期检测的现实途径。
