The effectiveness of ovarian cancer screening. A decision analysis model.

OBJECTIVE

To estimate the effectiveness of ovarian cancer screening with CA 125 and transvaginal sonography.

DESIGN

Decision analysis was used to examine the no-screen compared with the screen strategy.

SETTING

Estimates of cancer incidence, survival, and life expectancy were derived from population-based data and clinical series.

SUBJECTS

A cohort of 40-year-old women of all races and residing in the United States.

INTERVENTIONS

A one-time screening intervention. The criterion standard for diagnosis of ovarian cancer was evaluation with exploratory laparotomy.

MAIN OUTCOME MEASURE

Average years of life expectancy gained by women in the screened group.

RESULTS

Screening for ovarian cancer with a combination of CA 125 and transvaginal sonography increases the average life expectancy in the population by less than 1 day.

CONCLUSIONS

Given the limited effect on overall life expectancy, it is unlikely that mass screening for ovarian cancer with CA 125 and transvaginal sonography would be an effective health policy.