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Screening for Ovarian Cancer

TO THE EDITOR: The clinical guideline and review article on screening for ovarian cancer are concise, clear statements about this particular issue [1, 2]. As a practicing clinician, I appreciate the effort to provide guidance for a rational clinical approach to screening testing. One gray area related to this problem is the need for pelvic examinations in healthy, asymptomatic, previously screened (for cervical cancer) women between Papanicolaou tests. I generally do Papanicolaou tests every 3 years in my patients after establishing two or three normal test results within a year. How often pelvic examinations need to be done exemplifies the problem of complete physical examinations versus screening examinations. The practical significance of this question is the amount of time that must be allotted for doing screening maneuvers and the ability to integrate this screening into routine office visits. I have two questions for the authors. First, is there a justification or rationale for doing pelvic examinations in healthy, asymptomatic, previously screened women? Second, as a practical matter, do the authors do pelvic examinations on a more frequent basis than is required for Papanicolaou testing in healthy, asymptomatic, previously screened women?