IS EARLY DETECTION OF OVARIAN-CANCER POSSIBLE

Advances in medical technology have led to potentially useful techniqu es far the early detection of epithelial ovarian cancer, Early detecti on of ovarian cancer is crucial for survival as women found to have St age I or II disease have a 5-year survival of 90% and 70%, respectivel y, whereas those with advanced disease (Stage III and IV) have a survi val of approximately 20%, The circulating tumour marker CA-125 has bee n extremely useful in following women known to have epithelial ovarian cancers, It has been employed in differentiating benign tumours from malignancies, and is now being tested in a variety of programmes for i ts role in the early detection of ovarian cancer, The application of e ndovaginal ultrasound and colour Doppler flow techniques to early dete ction of ovarian cancer have resulted in several large series identify ing ovarian cancer in 1:1000 to 1:2000 postmenopausal women screened, However, a high false positivity rate persists using CA-125 and ultras ound techniques alone or in sequence, Developments in molecular geneti cs may be extremely useful in evaluating women with inherited suscepti bilities for this disease, but this probably represents only about 3% of the population of the women who develop epithelial ovarian cancer. The cost-benefit analysis of isolated screening for epithelial ovarian cancer using CA-125 and ultrasound techniques, even in women at high risk for the disease, would suggest that such screening is not cost-ef fective at this time.