Letters

Screening people with a family history of cancer

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7118.1306 (Published 15 November 1997) Cite this as: BMJ 1997;315:1306

Benefit of screening for ovarian cancer is unproved

  1. Ruth Bell, Senior registrar in public health medicinea,
  2. Mark Petticrew, Research fellowa
  1. a NHS Centre for Reviews and Dissemination, University of York, York YO1 5DD
  2. b Mill Stream Surgery, Benson, Wallingford, Oxfordshire OX10 6RL
  3. c Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN

    Editor—Dunlop and Campbell highlight the ad hoc development of NHS screening services for people with a family history of colorectal cancer.1 This problem is not confined to colorectal cancer; women with a family history of ovarian cancer are also at increased risk, and increasingly in Britain such women are being offered screening with ultrasonography and measurement of CA125 antigen.

    We recently undertook a systematic review of research into screening for ovarian cancer.2 Unlike with colorectal cancer, there is no evidence that screening reduces mortality. No randomised controlled trials have been completed, although several are under way; such trials are necessary to establish whether screening improves outcomes. It has been argued that screening for ovarian cancer should be offered to women with a family history simply because they are at increased risk. The increased prevalence of cancer in high risk women does not, however, alter the effectiveness of screening; it merely reduces the number of women screened to identify each case and increases …

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