SCREENING FOR OVARIAN-CANCER USING SERUM CA125 AND VAGINAL EXAMINATION - REPORT ON 2550 FEMALES

This study was undertaken to assess the effectiveness of using serum C A125 and vaginal examination as a screening test for ovarian cancer in apparently healthy females. Two thousand five hundred and fifty healt hy females aged 40 and over were recruited to participate in a screeni ng study involving a questionnaire, serum CA125 measurement and vagina l examination. Females with either an elevated CA125 level or abnormal vaginal examination had a pelvic ultrasound performed as a secondary procedure. The positive predictive values of an elevated serum CA125 l evel, and a combination of CA125 level measurement and vaginal examina tion for ovarian cancer, were 1/100 and 1/3, respectively. The specifi cities of serum CA125 levels, vaginal examination and both in combinat ion were 96.1%, 98.5% and 99.9%, respectively. In postmenopausal femal es the positive predictive values were improved with CA125 measurement alone, giving a positive predictive value of 1/24. Seventeen females underwent operative procedure as a result of the screening-only one of these was for an ovarian cancer. The combination of serum CA125 measu rement and vaginal examination is not an effective screening test in t he general population, although in postmenopausal females it does achi eve acceptable specificities and positive predictive values.