Early detection of ovarian tumors using ultrasound

Ovarian cancer can be treated with a very good prognosis if detected in the early stages, but not after it has advanced. Transvaginal ultrasound is capable of identifying changes in ovarian size and structure, and thereby detects early ovarian malignancies. This view has generated four major trials on transvaginal ultrasound detection: the Kentucky, PLCO, UKCTOCS, and SCSOCS trials. Each is sufficiently different to warrant examination. The Kentucky, UKCTOCS and SCSOCS trials report a shift to early stage detection. The Kentucky trial reports a survival benefit, while follow-up survival analysis is pending in the UKCTOCS and SCSOCS trials. Details of these trials are presented including definitions, inclusions/exclusions, analytic structure (intention-to-treat vs per protocol), performance (sensitivity, specificity, positive predictive value and negative predictive value), extent of screening-related treatment, time from screening to treatment, length of follow-up and survival versus mortality analysis. Questions are answered here about effectiveness, application, prevalence, cost and the potential for harm.