Ultrasound screening not useful in lowering mortality rates
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According to a study report published in The Lancet, long-term follow-up, neither multimodal screening (MMS) or transvaginal ultrasound screening (USS), significantly reduced deaths from ovarian and tubal cancer.

Ovarian cancer continues to have a poor prognosis with the majority of women diagnosed with advanced disease. Therefore, doctors undertook the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) to determine if population screening can reduce deaths due to the disease.

In this randomized controlled trial, postmenopausal women aged 50–74 years were recruited from 13 centers. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS), annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian or tubal cancer. Analyses were by intention to screen, comparing MMS and USS separately with no screening using the versatile test.

--Of 1243282 women invited, 202638 were recruited and randomly assigned, and 202562 were included in the analysis: 50625 in the MMS group, 50623 in the USS group, and 101?314 in the no screening group.

--At a median follow-up of 16·3 years, 2055 women were diagnosed with tubal or ovarian cancer: 522 of 50?625 in the MMS group, 517 of 50?623 in the USS group, and 1016 of 101?314 in the no screening group.

--Compared with no screening, there was a 47·2% increase in stage I and a 24·5% decrease in stage IV disease incidence in the MMS group.

--Overall the incidence of stage I or II disease was 39·2% higher in the MMS group than in the no screening group, whereas the incidence of stage III or IV disease was 10·2% lower.

--1206 women died of the disease: 296 of 50625 in the MMS group, 291 of 50623 in the USS group, and 619 of 101314 in the no screening group.

--No significant reduction in ovarian and tubal cancer deaths was observed in the MMS or USS groups compared with the no screening group.

In summary, the reduction in stage III or IV disease incidence in the MMS group was not sufficient to translate into lives saved, illustrating the importance of specifying cancer mortality as the primary outcome in screening trials. Given that screening did not significantly reduce ovarian and tubal cancer deaths, general population screening cannot be recommended.

Source: https://doi.org/10.1016/S0140-6736(21)00731-5
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