According to this study:

* Genomic tests do not decrease mortality or improve quality of life.

* Research aimed at improving prevention and treatment may be more beneficial.

Routine screening methods such as physical examination and ultrasonography have been unsuccessful in identifying ovarian cancer in its early stages, both in high-risk patients and in the general population. Consequently, interest exists in identifying gene-based tumor markers such as CA-125 and testing for mutations in the BRCA1 and BRCA2 tumor-suppressing genes to indicate increased disease risk, likely responses to therapy, or both. However, according to a recent review of the literature, many genomic tests used to diagnose and guide the treatment of ovarian cancer neither decrease mortality rates nor improve the quality of patients' lives.

The researchers reviewed the English-language literature for the sensitivity and specificity of the available tests, evidence that testing changes clinical management and leads to better outcomes, and evidence that testing might cause harm. (They found few studies that evaluated genetic tests other than those for CA-125 or for BRCA1 and BRCA2 polymorphisms.)

Modeling suggested that screening would need to be more frequent than yearly, even with a highly sensitive test, to reduce mortality rates from ovarian cancer by more than 50%. Additionally, frequent screening has a very low positive predictive value, even with a highly specific test.

Therefore, the researchers write, the integration of genomic tests into clinical practice must await appropriate studies. "Screening is not the best strategy for preventing ovarian cancer," concludes principle investigator Evan Myers, MD, MPH. Most cases are discovered in the advanced stage, "and the disease progresses so rapidly there isn't time to screen." Instead, researchers need to develop primary prevention strategies.