Ovarian cancer identified through screening with serum markers but not by pelvic imaging

This study evaluated the possible role of 3 additional tumor markers to CA 125 among postmenopausal volunteers participating in a sequential multimoda l ovarian cancer screening study. In 82 asymptomatic women the finding of a serum CA 125 level of > 30 U/ml precipitated pelvic ultrasound examination . Levels of CA15-3, CA72-4 and CA19-9 were subsequently determined in sera stored from the time of the CA 125 assay. Following ultrasound 29 women und erwent surgery for benign conditions. The remaining 53 women underwent 2 ye ars of surveillance. In 5 of these women a diagnosis of ovarian cancer was established between 6 and 10 months after their initial investigation. Elev ated levels of at least one of the 3 additional tumor markers were present in the serum, prior to ultrasound abnormalities being detected, in 4 (80%) of the women who developed cancer. At least one of this 3-marker panel was elevated in 29% of the 48 women who have not developed cancer and 14% of th e 29 women undergoing surgery for benign conditions. Information complement ary to pelvic ultrasound examination for the preclinical detection of ovari an cancer could be obtained through multiple marker assay. Coordinated elev ated serum levels of tumor markers could increase the sensitivity of this s equential screening protocol.