Why is it important to screen for ovarian cancer?

Ovarian cancer is the leading cause of death among gynecological malignancies in the United States and early ovarian cancers often do not demonstrate visible symptoms, and most signs get overlooked easily. When it comes to ovarian cancer, most of the visible symptoms begin only when the disease has progressed to an advanced stage.

Basis of Screening:

Survival of ovarian cancer {insert survival rate of Ovarian Cancer article here} depends on the stage at the time of diagnosis. 5-year survival rate is more than 90% in some patients with stage 1 ovarian cancer, where as it drops to 25% in patients with stage IV ovarian cancer. Despite good prognosis with early stage disease, the overall 5 year survival is less than 45% because of the spread of the cancer beyond ovaries in majority of the patients. Hence, early detection with screening can improve mortality rate and overall survival.

Women who are at an increased risk of developing ovarian cancer, such as those who have a family history of cancer should consider getting screened regularly, in order to be on the safer side. Screening is performed in the absence of symptoms, in order to eliminate the possibility of cancer in candidates who are at high-risk. If cancer gets detected during screening, it can be diagnosed and treated early and more effectively.

What are the different screening systems available for ovarian cancer?

The different types of tests, processes, and infrastructure used to screen for ovarian cancer are as follows:

Transvaginal Ultrasound (TVS)

The transvaginal ultrasound is a device that uses sound waves to look at the ovary, fallopian tubes and the uterus by inserting an ultrasound wand into the vagina. This type of testing is used to identify a mass or tumor in the ovary. It cannot identify if the mass is cancerous or benign. Studies have shown that most masses found through this type of testing
are not cancerous.

CA-125 blood test

The CA-125 test is a blood test that is used to measure the levels of the protein CA-125 in the blood. Most women with ovarian cancer present with high levels of CA-125 in their blood. CA-125 is increased in 50% of patients with early Ovarian cancer and in 80% of the patients with advanced disease.

The main disadvantage of this tumor marker is that its specificity is limited. It is raised in other conditions apart from ovarian cancer. These conditions are endometriosis, uterine leiomyosarcoma, pelvic inflammatory disease, cancers of breast, endometrium, lung and pancreas.

Risk of ovarian cancer algorithm (ROCA)

ROCA screening is a statistical tool that is used to check the risk of developing ovarian cancers based on a specific woman’s age and changes in the levels of the protein CA-125 over a period of time. The ROCA test is also sensitive enough to rule out the possibility of ovarian cancer at its earliest stages (Stages 1 and 2).

Screening tests for germ cell tumors and stromal tumors

Germ cell tumors or stromal tumors do not come with a recommended set of screening tests, but it has been observed that the most common protein markers seen in germ cell tumors are human chorionic gonadotropin (HCG) and alpha-fetoprotein. These protein markers can be detected through a simple blood test. After these markers have been detected, the most common form of treatment given for germ cell tumors or stromal tumors, is usually surgery or chemotherapy. A blood test for these markers can also be performed to check if a patient’s cancer is recurring or relapsing, or if a patient’s ongoing treatment is working as planned.

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