Abstract #302221

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JSM 2003 Abstract #302221
Activity Number: 103
Type: Invited
Date/Time: Monday, August 4, 2003 : 10:30 AM to 12:20 PM
Sponsor: WNAR
Abstract - #302221
Title: Screening for Ovarian Cancer with a First Line Blood Test
Author(s): Steven J. Skates*+
Companies: Massachusetts General Hospital
Address: Suite 560, Biostatistics Center, Boston, MA, 02114-2517,
Keywords: population screening ; ovarian cancer ; blood test ; longitudinal ; change-point ; screening trials
Abstract:

Screening for ovarian cancer is an appealing approach to reducing mortality from this disease. When detected in early stage prognosis is excellent. Unfortunately the majority of cases (75%) are detected in late stage with corresponding poor prognosis. Population screening programs may shift detection of a large fraction of cases from late to early stage. However with an annual incidence of 1 in 2,000 or more in postmenopausal women, screening needs to be extremely accurate so that true positives are not overwhelmed by false positives. A blood test as the first line test followed by imaging is one approach to screening. We investigate a statistical approach to improving the ratio of true to false positives, while still detecting a large fraction of true positives. Longitudinal hierarchical methods model the behavior of marker values over time in cases and controls. Parameter estimates from these models enable calculation of the risk given serial markers in a new subject. Screening decisions based on the risk are more accurate than when based on the last marker levels. We discuss this approach in the context of current screening trials.

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