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The Effectiveness of Ovarian Cancer Screening: A Decision Analysis Model
- Marilyn M. Schapira, MD, MPH;
- David B. Matchar, MD; and
- Mark J. Young, MD
- From the Medical College of Wisconsin, Milwaukee, Wisconsin; Duke University Medical Center, Durham, North Carolina; Henry Ford Hospital, Detroit, Michigan. Requests for Reprints: Marilyn M. Schapira, MD, Section of General Internal Medicine, 5000 W. National Avenue, Clement J. Zablocki Veterans Affairs Medical Center, 111-B, Milwaukee, WI 53295-1000. Acknowledgments: The authors thank John Pauk, MD, MPH, for review of the manuscript.
Abstract
Objective: To estimate the effectiveness of ovarian cancer screening with CA 125 and transvaginal sonography.
Design: Decision analysis was used to examine the no-screen compared with the screen strategy.
Setting: Estimates of cancer incidence, survival, and life expectancy were derived from population-based data and clinical series.
Subjects: A cohort of 40-year-old women of all races and residing in the United States.
Interventions: A one-time screening intervention. The criterion standard for diagnosis of ovarian cancer was evaluation with exploratory laparotomy.
Main Outcome Measure: Average years of life expectancy gained by women in the screened group.
Results: Screening for ovarian cancer with a combination of CA 125 and transvaginal sonography increases the average life expectancy in the population by less than 1 day.
Conclusions: Given the limited effect on overall life expectancy, it is unlikely that mass screening for ovarian cancer with CA 125 and transvaginal sonography would be an effective health policy.
- Copyright 2004 by the American College of Physicians
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