Screening for ovarian cancer is currently unproven as a strategy for improving outcomes for women with ovarian cancer. Screening programmes should therefore not be considered until further research provides a better understanding of the potential benefits, harms and costs involved. While awaiting the results of the current trials, demand for screening is likely to increase, and a strong national lead on this is required.
RCTs currently underway should, in 5-7 years time, give an estimate of any impact of screening on ovarian cancer mortality.
The relatively low prevalence of ovarian cancer means that the positive predictive value of screening tests, even those with very high specificity, is low. Since the consequence of a false positive result is a surgical procedure, consideration of the overall impact of ovarian cancer screening, and not only the potential benefits, is important. The low prevalence also limits the potential cost-effectiveness of population screening.
The balance of potential benefits, harms and costs of screening may be more favourable in the small group of women who are at significantly increased risk due to a strong family history. However, benefit from screening has not been established and therefore there is no case for establishing a screening programme in this group.