THE EFFECTIVENESS OF OVARIAN-CANCER SCREENING - A DECISION-ANALYSIS MODEL

Objective: To estimate the effectiveness of ovarian cancer screening with CA 125 and transvaginal sonography. Design: Decision analysis was used to examine the no-screen compared with the screen strategy. Setting: Estimates of cancer incidence, survival, and life expectancy were derived from population-based data and clinical series. Subjects: A cohort of 40-year-old women of all races and residing in the United States. Interventions: A one-time screening intervention. The criterion standard for diagnosis of ovarian cancer was evaluation with exploratory laparotomy. Main Outcome Measure: Average years of life expectancy gained by women in the screened group. Results: Screening for ovarian cancer with a combination of CA 125 and transvaginal sonography increases the average life expectancy in the population by less than 1 day. Conclusions: Given the limited effect on overall life expectancy, it is unlikely that mass screening for ovarian cancer with CA 125 and transvaginal sonography would be an effective health policy.