The most intensively investigated serum tumour marker is CA 125. Problems encountered include the fact that it is not specific for ovarian cancer, and there is a lack of specificity and sensitivity particularly in early disease. Because of the low incidence of the disease it is difficult to attain a high positive predictive value from the screening tool. This is particularly important in ovarian screening where a positive test may result in laparotomy. A major drawback is the lack of a randomised controlled trial to show a reduction in mortality from screening.
Ovarian cancer is a high profile media issue.
This often results in women requesting advice. Thus a decision must be made on what can be identified as best practice based on the available evidence. There is no evidence to support screening asymptomatic women in the general population for ovarian cancer. There is no evidence as yet to support actively seeking these women out in the community, as due to the lack of RCT evidence on reduction in mortality, benefit cannot be guaranteed. If a woman with this history presents requesting screening, she should be referred for further advice.