Abstract:
Ovarian Cancer is the second most common gynecologic malignancy and the most common cause of death amongst women with gynecologic cancer. Worldwide 239,000 new cases of were diagnosed in 2012. In the US alone, 22,000 new cases of ovarian are diagnosed annually and 14,000 women die from ovarian cancer each year. The five-year survival rate for ovarian cancer is directly related to stage at diagnosis, which is at 90% for stage I and sharply falls to 25% for stage III. Although ovarian cancer screening is not recommended for the general population, it is crucial to identify at risk population including patients with Lynch syndrome, BRCA mutations etc. to offer them multimodal screening at an early age to detect ovarian cancer at an early stage. There has not been consensus between ACOG, NCCN, and USPSTF on whether screening high-risk population has a significant impact on cancer related mortality. Various biomarker panels and multimodal tests and their role in ovarian cancer screening has been an active area of investigation. These include OVA 1®, HE4, Risk of Malignancy Algorithm (ROMA), Risk of Malignancy Index which are currently recommended for risk stratification of patients with adnexal mass prior to deciding the surgical approach. There are other tests like OVERA® that have recently been added to this list, and more studies are needed to determine the risk-benefit and costs-benefit ratios of these tests in effective screening of ovarian cancer.
