The review included 4 studies reporting the diagnostic performance of pelvic examination, 4 screening studies using abdominal ultrasound (n=8,162; a total of 10 participants with cancer), 3 screening studies using transvaginal ultrasound (n=2,953; a total of 10 participants with cancer), and 3 screening studies using CA-125 (n=28,642; a total of 26 participants with cancer).
In addition, 5 case series using abdominal ultrasound (n=677; a total of 178 participants with cancer), 2 case series using transvaginal ultrasound (n=323; a total of 49 participants with cancer), and 17 case series using CA-125 (n=1,923; a total of 912 participants with cancer) in women with known or suspected OC, were also included in the review.
Pelvic examination was of limited value in screening for OC, although little data are available. Ultrasound had a summary sensitivity of 85% (95% confidence interval, CI: 80, 90) and a summary specificity of 93.8% (95% CI: 93.3, 94.3). Ultrasound had a predictive value of 1% in 50-year-old women, and 2% in women who had a relative with OC.
CA-125 had an overall summary sensitivity of 78% (95% CI: 73, 83), and a summary specificity of 98.9% (95% CI: 98.6, 99.2). CA-125 had a sensitivity of around 46 and 92% in detecting Stage I and Stage II OC, respectively. CA-125 had a predictive value of 3% in 50-year-old women of average risk, and 10% in those with a relative with OC.