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Combo Screening Doesn't Spot Early Ovarian Cancer
Date:3/20/2009

Even finding it early may not save lives, researchers say,,,,

FRIDAY, March 20 (HealthDay News) -- A screening regimen that combines ultrasound and a blood test to detect CA125, a marker for ovarian cancer, fails to discover the cancer in its early stages and often results in unnecessary surgery, a new study shows.

This finding contrasts with another recent study that found that these same two tests did find early cancer. Taken together, experts say these studies highlight the need to find an effective screening method for this deadly cancer, which is often called the "silent killer."

"The jury is still out on the efficacy of screening with CA125 and transvaginal ultrasound in terms of reducing the mortality rate of ovarian cancer," said lead researcher Dr. Edward Partridge, director of the University of Alabama Birmingham Comprehensive Cancer Center.

"In this study, we do not have mortality data on the screening versus the non-screening group, so no conclusions can be made of the impact of screening with CA125 and transvaginal ultrasound," he added.

This study only reports data on women who were screened, Partridge noted. "We learned that the positive predictive value for the combination of tests is pretty low -- in the 1 to 1.3 percent range," he said. "A substantial number of the tests are false positives."

In addition, screening with transvaginal ultrasound lead to a higher rate of surgery for positive findings than positive CA125, Partridge said. "Transvaginal ultrasound leads to more 'unnecessary' surgeries," he said.

And a high percentage of the cancers detected through screening were late-stage malignancies, Partridge said. "If you detect them at a late stage, it is unlikely that you are going to impact mortality," he said. "In order to affect mortality, one has to detect them at an earlier stage."

The report is published in the April issue of Obstetrics & Gyne
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