Current status of screening for ovarian cancer.

Many women are requesting tests to screen for ovarian cancer. Extensive media coverage of this disease probably stimulates demand for these tests. Published reports from ovarian cancer screening programs have not yet demonstrated any benefit of screening. Existing programs have largely reported only the number of cancers detected during a single round of screening. Among 36,000 screened subjects reported on, 29 ovarian cancers have been detected; 12 of these were Stage I. All programs report that considerable surgery for benign disease has occurred among subjects. Follow-up, thus far, has been brief, and no control groups are included. Several new screening programs include only women with a family history of ovarian cancer. These programs also lack control groups and have little follow-up to date. A prospective, randomized trial of ovarian cancer screening to include 74,000 postmenopausal women has been initiated by NCI as part of the PLCO trial. Results from this trial should quantify the risks and benefits of screening; however, results will not be available for many years. Until there are data to show that screening reduces mortality from ovarian cancer, clinicians should not suggest these tests are beneficial, and they should avoid performing these tests outside of research protocols.