Ovarian cancer screening
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* David M. Allen

*   © 2005 Canadian Medical Association or its licensors

Usha Menon,1 in an analysis of ovarian cancer screening, points out that the best evidence for screening comes from a study that found significant longer median survival with screening but no significant difference in the number of deaths from ovarian or fallopian tube cancer.2 This sounds like a classic example of lead-time bias, in which earlier diagnosis of a disease has no impact on the patient's outcome. In other words, the patient may die of the disease at the same time as she would have if the diagnosis had been made 30 months later. Median survival may appear better, but in fact all we've done is to give the patient a longer cancer experience, without better quality or quantity of life.

If this is the best evidence we have for ovarian cancer screening, then I certainly agree that “Screening is not currently recommended for the general population.”

## References

1.  1. Menon U. Ovarian cancer screening. CMAJ 2004; 171(4):323-4.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNzEvNC8zMjMiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTcyLzQvNDQ3LjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. Jacobs IJ, Skates SJ, MacDonald N, Menon U, Rosenthal AN, Davies AP, et al. Screening for ovarian cancer: a pilot randomised controlled trial. Lancet 1999;353(9160):1207-10.
    
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    [Web of Science](http://www.cmaj.ca/lookup/external-ref?access_num=000079744100007&link_type=ISI)