Early detection of ovarian cancer

Ovarian cancer is usually diagnosed after reaching an advanced stage, in part because of the nonspecific nature of the presenting symptoms. A method of early detection is urgently needed because of the stark difference in long-term survival between early- and late-stage disease. A useful screening test must be easy to perform, low cost, safe and have high positive-predictive value in order to reduce the number of unnecessary invasive procedures performed. A variety of modalities – from pelvic examination to transvaginal ultrasound to cancer antigen 125 to serum biomarker panels and proteomic and other novel approaches – have been explored as possible tests to detect early disease. To date, an effective screening approach has yet to be introduced to clinical practice. Here, the authors evaluate the approaches and highlight promising areas of new research aimed at improving early detection of ovarian cancer.