CTF Summary Table: Screening for ovarian cancer

Canadian Task Force on Preventive Health Care

Summary Table of Recommendations

Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.

Screening for Ovarian Cancer

Prepared by Cindy Quinton Gladstone, MHSc, MD, FRCPC, Research Associate, Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario

These recommendations were finalized by the Task Force in January 1994

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

For Asymptomatic Pre- and Post-Menopausal Women

Screening by pelvic exam, ultrasound, transvaginal sonography (TVS), serum tumour antigen (e.g CA 125) or combination. Poor positive predictive value for early detection of ovarian carcinoma. Effectiveness of screening unknown. Case series <2,11-24,30,31> (III) and case-control studies (for CA 125 only) <26-29> (II-2) Fair evidence to exclude screening for ovarian cancer by any means for pre- and post-menopausal women. (D)

Evidence of harm from diagnostic laparotomy. Case series <37-40> (III)

Few well-controlled studies on treatment; better prognosis with early stage cancers. Randomized controlled trials<34-36> (I) and case series<32,33> (III) for various therapies

For High-Risk Women with >1 First-degree Relative with Ovarian Cancer

Multimodal screening (pelvic exam, TVS, CA 125).** Evidence of higher positive predictive value for detection because of higher prevalence in this group. Effectiveness of screening unknown. Case series <4> (III) Insufficient evidence to recommend for or against screening. (C)

* The frequency of screening recommended by experts in this area is twice yearly. There is little evidence to support this.

Link to Full Text of this review

Link to Structured Abstract of this review

Link to Selected References list of this review

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
For Asymptomatic Pre- and Post-Menopausal Women
Screening by pelvic exam, ultrasound, transvaginal sonography (TVS), serum tumour antigen (e.g CA 125) or combination.	Poor positive predictive value for early detection of ovarian carcinoma. Effectiveness of screening unknown.	Case series <2,11-24,30,31> (III) and case-control studies (for CA 125 only) <26-29> (II-2)	Fair evidence to exclude screening for ovarian cancer by any means for pre- and post-menopausal women. (D)
	Evidence of harm from diagnostic laparotomy.	Case series <37-40> (III)
	Few well-controlled studies on treatment; better prognosis with early stage cancers.	Randomized controlled trials<34-36> (I) and case series<32,33> (III) for various therapies
For High-Risk Women with >1 First-degree Relative with Ovarian Cancer
Multimodal screening (pelvic exam, TVS, CA 125).**	Evidence of higher positive predictive value for detection because of higher prevalence in this group. Effectiveness of screening unknown.	Case series <4> (III)	Insufficient evidence to recommend for or against screening. (C)