Screening program in ovarian cancer: A logical step in clinical management? A meta-analysis

Publication date: Available online 5 January 2018
Source:Current Problems in Cancer
Author(s): Claudia Marchetti, Francesca De Felice, Giorgia Perniola, Francesca Lecce, Laura Vertechy, Marco Monti, Daniela Musio, Ludovico Muzii, Vincenzo Tombolini, Pierluigi Benedetti Panici
ObjectiveTreatment of ovarian cancer is a challenge and its poor prognosis still remains a problem of major importance. Due to the lack of early and specific symptoms, the vast majority of women are diagnosed with an advanced stage disease. The aim of this meta-analysis is to evaluate the impact of ovarian cancer screening program in asymptomatic women on clinical outcomes.Methods and materialA systematic literature electronic search was conducted in Pubmed, Medline, Scopus and ClinicalTrials.gov databases. Articles were selected with a systematic approach. Clinical trials concerning screening strategy compared with usual care in asymptomatic ovarian cancer women were considered, without any restrictions on the publication date. Trials were eligible if participants were asymptomatic and post-menopausal women. Outcomes included ovarian cancer diagnosis and disease specific mortality. The pooled relative risk was calculated using a fixed-effects model.ResultsOverall, three randomized controlled trials met inclusion criteria, totaling 353,590 asymptomatic women. In total 177,188 women were assigned to screening program, and 176,402 women were assigned to usual care. The risk of ovarian cancer diagnosis, both overall and at an early stage, was higher in screening group (relative risk 1.07, 95% confidence interval, 0.98–1.18; and relative risk 1.30, 95% confidence interval, 1.14–1.49, respectively). The relative risk for disease specific mortality was 0.96 (95% confidence interval, 0.85–1.10).ConclusionOur results suggest the possible benefit of ovarian cancer screening program in term of early stage diagnosis and reduced specific ovarian cancer mortality. Further studies of environmental and/or constitutional factors may lead to the identification of patient populations that could benefit from a screening program.



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