ABSTRACT

ABSTRACT In 2008, ovarian cancer was the seventh most common cancer in women worldwide, and incidence rates were highest in developed countries. Survival from ovarian cancer is related to the stage at diagnosis; 5-year survival is over 90% for the minority of women with stage I disease. This drops to about 75%–80% for regional disease and 25% for those with distant metastases. The potential benet of screening is its ability to identify ovarian cancer at a more localized and curable stage, leading to reduced mortality from the disease. Interest in early detection as a method of reducing mortality has grown with the discovery of serum tumor markers associated with ovarian malignancies and with improved diagnostic accuracy of pelvic ultrasonography. Intensive research is ongoing to identify additional markers and a cost-effective screening strategy. Measurement of the serum concentration of the cancer antigen (CA) 125 glycoprotein antigen is the most widely studied biochemical method of screening for ovarian cancer. Serum CA125 values are elevated in approximately 50% of women with early-stage disease and in over 80% of women with advanced ovarian cancer. Human epididymis protein 4 (HE4) appears to have a similar sensitivity to CA125 when comparing serum from ovarian cancer cases to healthy controls and a higher sensitivity when comparing ovarian cancer cases to benign gynecological disease. HE4 addition in combination with CA125 appears to be an effective tool for early detection of recurrence or monitoring response to treatment.