Ovarian cancer screening

Usha Menon

doi:10.1503/cmaj.1031298

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Ovarian Screening
David M Allen

Posted on: 27 September 2004
misquote
erica l eason

Posted on: 09 September 2004

Posted on: (27 September 2004)

Ovarian Screening
David M Allen, 410-65 Larch St. Sudbury, ON P3E 1B8
Usha Menon, in an analysis of ovarian cancer screening, pointed out that the best evidence for screening for ovarian cancer came from a study that found a sigificant difference in median survival with screening without finding an actual difference in the number of deaths from ovarian or fallopian tube cancer. This sounds like it could be a classic example of lead time bias, in which we make an earlier diagnosis in a dis...
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Usha Menon, in an analysis of ovarian cancer screening, pointed out that the best evidence for screening for ovarian cancer came from a study that found a sigificant difference in median survival with screening without finding an actual difference in the number of deaths from ovarian or fallopian tube cancer. This sounds like it could be a classic example of lead time bias, in which we make an earlier diagnosis in a disease where we make no impact on the outcome of the disease. The patient may die of the disease at the same time as if the diagnosis had been made thirty months later. Median survival may appear better, but in fact all we've done is given the patient a longer cancer experience, without giving them a better quality or quantity of life. If this is the best evidence for ovarian cancer screening, then I certainly agree that "Screening is not currently recommended for the general population".
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (9 September 2004)

misquote
erica l eason
Dear editor,
Usha Menon's review of ovarian cancer screening misquotes the result of the randomised controlled trial of screening with CA 125 and ultrasonography by Jacobs et al. The correct number of deaths from ovarian cancer was 18/10,977 in the control group and 9/10,958 in the screened group (RR of death in the unscreened group 2.0, 95% CI 0.78- 5.13). (The article stated the reverse.) While the difference...
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Dear editor,
Usha Menon's review of ovarian cancer screening misquotes the result of the randomised controlled trial of screening with CA 125 and ultrasonography by Jacobs et al. The correct number of deaths from ovarian cancer was 18/10,977 in the control group and 9/10,958 in the screened group (RR of death in the unscreened group 2.0, 95% CI 0.78- 5.13). (The article stated the reverse.) While the difference in deaths is not statistically significant, this represents a possible halving of the death rate by screening, rather than a possible doubling.
Sincerely, Erica Eason, MDCM, FRCSC. Associate professor, obstetrics & gynaecology, U of Ottawa.
Conflict of Interest:
None declared
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Competing Interests: None declared.