Ovarian Cancer Screening: Recommendations and Future Prospects

Abstract

Background

Ovarian cancer remains a significant cause of mortality among women, largely due to challenges in early detection. Current screening strategies, including transvaginal ultrasound and CA125 testing, have limited sensitivity and specificity, particularly in asymptomatic women or those with early-stage disease. The European Society of Gynaecological Oncology, the European Society for Medical Oncology, the European Society of Pathology, and other health organizations currently do not recommend routine population-based screening for ovarian cancer due to the high rates of false-positives and the absence of a reliable early detection method.

Method

This review examines existing ovarian cancer screening guidelines and explores recent advances in diagnostic technologies including radiomics, artificial intelligence, point-of-care testing, and novel detection methods.

Results and Conclusion

Emerging technologies show promise with respect to improving ovarian cancer detection by enhancing sensitivity and specificity compared to traditional methods. Artificial intelligence and radiomics have potential for revolutionizing ovarian cancer screening by identifying subtle diagnostic patterns, while liquid biopsy-based approaches and cell-free DNA profiling enable tumor-specific biomarker detection. Minimally invasive methods, such as intrauterine lavage and salivary diagnostics, provide avenues for population-wide applicability. However, large-scale validation is required to establish these techniques as effective and reliable screening options.

Key Points

• Current ovarian cancer screening methods lack sensitivity and specificity for early-stage detection.

• Emerging technologies like artificial intelligence, radiomics, and liquid biopsy offer improved diagnostic accuracy.

• Large-scale clinical validation is required, particularly for baseline-risk populations.

Citation Format

• Chiu S, Staley H, Jeevananthan P et al. Ovarian Cancer Screening: Recommendations and Future Prospects. Rofo 2025; DOI 10.1055/a-2589-5696

Zusammenfassung

Hintergrund

Ovarialkarzinome sind nach wie vor eine der häufigsten Todesursachen bei Frauen, was vor allem auf die Schwierigkeiten bei der Früherkennung zurückzuführen ist. Aktuelle Screening-Strategien, darunter die transvaginale Sonografie und die CA125-Bestimmung, haben eine geringe Sensitivität und Spezifität insbesondere bei asymptomatischen Frauen oder bei einer im Frühstadium befindlichen Erkrankung. Die „European Society of Gynaecological Oncology“, die „European Society for Medical Oncology“, die „European Society of Pathology“ und andere medizinische Fachgesellschaften sprechen aktuell keine Empfehlung für ein Ovarialkarzinom-Routinescreening in der Bevölkerung aus, da die Rate falsch-positiver Ergebnisse hoch ist und eine zuverlässige Früherkennungsmethode fehlt.

Methoden

In dieser Übersicht werden die aktuellen Leitlinien für das Ovarialkarzinom-Screening vorgestellt und die jüngsten Fortschritte bei diagnostischen Technologien wie Radiomics, künstliche Intelligenz, Point-of-Care-Tests und neuartige Nachweismethoden analysiert.

Ergebnisse und Schlussfolgerung

Die neuen Technologien sind vielversprechend, da sie verglichen mit herkömmlichen Methoden höhere Sensitivität und Spezifität aufweisen und somit die Diagnose von Ovarialkarzinomen verbessern. Künstliche Intelligenz und Radiomics können die Früherkennung von Ovarialkarzinomen durch die Identifizierung subtiler diagnostischer Muster revolutionieren, während auf Liquid-Biopsy basierende Ansätze und Profiling zellfreier DNA den Nachweis tumorspezifischer Biomarker ermöglichen. Minimalinvasive Methoden wie intrauterine Lavage und die Speicheldiagnostik bieten die Möglichkeit für eine breite Anwendbarkeit. Es ist jedoch eine umfangreiche Validierung erforderlich, um diese Techniken als wirksame und zuverlässige Screening-Optionen zu etablieren.

Kernaussagen

• Die aktuellen Methoden zur Früherkennung von Ovarialkarzinomen sind nicht zuverlässig.

• Neue Technologien wie künstliche Intelligenz, Radiomics und Liquid-Biopsy bieten eine verbesserte diagnostische Genauigkeit.

• Eine groß angelegte klinische Validierung ist erforderlich, insbesondere für Populationen mit erhöhtem Risiko.

Keywords

Ovarian cancer - Biomarkers - Early detection - Artificial intelligence - Radiomics - screening

Publikationsverlauf

Eingereicht: 02. Januar 2025

Angenommen nach Revision: 07. April 2025

Artikel online veröffentlicht:
23. Mai 2025

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