ACR Appropriateness Criteria® Ovarian Cancer Screening: 2024 Update

Aradhana M. Venkatesan, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: avenkatesan@mdanderson.org.
Aoife Kilcoyne, Panel Chair, Massachusetts General Hospital, Boston, Massachusetts.
Esma A. Akin, George Washington University Hospital, Washington, District of Columbia; Commission on Nuclear Medicine and Molecular Imaging.
Linus Chuang, University of Vermont Larner College of Medicine Danbury Hospital, Burlington, Vermont; Society of Gynecologic Oncology.
Nicole M. Hindman, New York University School of Medicine, New York, New York.
Chenchan Huang, New York University Langone Medical Center, New York, New York.
Carolyn Kay McCourt, Washington University School of Medicine, Saint Louis, Missouri; American College of Obstetricians and Gynecologists.
Gaiane M. Rauch, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Maryam Sattari, University of Florida College of Medicine, Gainesville, Florida; Society of General Internal Medicine.
Nancy Schoenborn, Johns Hopkins University School of Medicine, Baltimore, Maryland; American Geriatrics Society.
David Schultz, Evansville Primary Care, Evansville, Indiana; American Academy of Family Physicians.
Madeleine Sertic, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
William Small, Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, Illinois; Commission on Radiation Oncology.
Erica B. Stein, University of Michigan Medical Center, Ann Arbor, Michigan.
Krista Suarez-Weiss, Harvard University, Boston, Massachusetts.
Stella K. Kang, Specialty Chair, New York University Medical Center, New York, New York.

Document Type

Journal Article

Publication Date

5-1-2025

Journal

Journal of the American College of Radiology : JACR

Volume

22

Issue

5S

DOI

10.1016/j.jacr.2025.02.016

Keywords

AUC; Appropriateness Criteria; appropriate use criteria; gynecology; imaging; ovarian cancer; radiology; screening; ultrasound

Abstract

Ovarian cancer remains low in prevalence but has the highest mortality of all gynecologic malignancies. Population-based screening for ovarian cancer remains a topic of interest in contemporary practice, given that the majority of cancers encountered are high-grade aggressive malignancies, for which favorable survival is encountered in the setting of early-stage disease. This document summarizes a review of the available data from randomized and observational trials that have evaluated the role of imaging for ovarian cancer screening in average-risk and high-risk patients. When considering screening using pelvic ultrasound in average-risk patients, we found insufficient published evidence to recommend ovarian cancer screening. Randomized controlled trials have not demonstrated a mortality benefit in this setting. Screening with pelvic ultrasound may be appropriate for select patients at high risk, although the existing data remain limited as large, randomized trials have not been performed in this setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Department

Radiology

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