To date results on morbidity, mortality and quality of life of four randomized controlled trials investigating screening versus no screening for ovarian cancer have been published [
7,
9‐
12]. The two largest with results on overall survival are described here in more detail [
7,
9]. The Prostate, Lung, Colorectal, and Ovarian (PLCO) trial evaluated the effect of screening on ovarian cancer mortality in 39,105 postmenopausal women using annual screens with serum CA-125 (threshold of 35 U/mL) and TVU compared to usual care (
n = 39,111) [
9]. Neither stage distributions nor mortality of ovarian cancer differed between the groups. However, of the 1080 women who underwent surgical follow-up, 163 women experienced at least one serious complication (15%). The largest and most recent trial, the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), enrolled 202,546 participants through 13 National Health Service Centers in England, Wales, and Northern Ireland. Included women were 50 to 74 years of age, postmenopausal and did not have increased risk of familial ovarian cancer [
7]. Women were randomly assigned to 7 to 11 rounds of annual screening with transvaginal ultrasound alone, multimodal screening with CA-125 testing and TVU, or no screening at all. The ROCA was used for triaging women to further follow-up. Although a higher rate of low-volume disease (stage I, II and IIIA) was detected by multimodal screening (119 [40%] of 299;
p < 0.0001) compared to no screening (149 [26%] of 574), mortality was nonsignificantly lower with TVU or multimodal screening (9% [−9 to 24],
p = 0.31 and 11% [8 to 26],
p =0.23, respectively). In 44.2% of women without cancer screened in the multimodal group at least one test result was falsely positive. False-positive surgeries were done in 14 per 10,000 screens of multimodal and 50 per 10,000 screens of TVU screening. Complications occurred in 3.1 and 3.5% of women of the multimodal and TVU screening groups, respectively.