Editorial: A Step Forward for Two-Step Screening for Ovarian Cancer - Journal of Clinical Oncology

A Step Forward for Two-Step Screening for Ovarian Cancer
  Martee L. Hensley, Department of Medicine, Gynecologic Medical Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY

See accompanying article doi: 10.1200/JCO.19.2484
".. If the four-biomarker assay is to become a standard for screening postmenopausal women for early-stage ovarian cancer, the next step needs to be a giant one: a prospective, randomized trial for postmenopausal normal-risk women, comparing four-biomarker assay screening, followed by transvaginal sonogram for women with an abnormal assay compared with no screening. The end point, ideally, should be survival.

Given the questions about potential biologic differences in behavior of early-stage– versus late-stage–presenting ovarian cancer, an end point of greater detection of early-stage cancer, although attractive, is unlikely to be definitive. Particularly in ovarian cancer, over diagnosis has the potential to do harm. We all hope to be able to tell women that ovarian cancer screening can increase survival.We are not there yet, but we may be one step closer."