Paquette, Gregory E
ovarian cancer; diagnosis; early onset; ca-125; he-4
Epithelial ovarian cancer is the most lethal gynecologic malignancy with very ineffective efforts at early detection and therapeutic methodologies to reduce mortality. The origin and pathogenicity of ovarian cancer is vastly unclear, which is why diagnosing the disease early on is difficult. CA-125 is a used as therapeutic tumor marker for ovarian cancer, but it is not diagnostic or specific. The role of CA-125 in the early detection of ovarian cancer is extremely controversial and has not been widely accepted for screening in women who do not show any symptoms. In order to enhance the sensitivity for early disease detection there have been three notable advances taken; current research to diagnose early-onset cancer includes obtaining longitudinal measurements of CA-125 to calculate the probability of ovarian cancer for a patient using the Bayesian algorithm, using tumor marker Human Epididymis Protein (HE4) in combination with CA-125 to screen asymptomatic women in the general population through genomic strategies and the development of algorithms Risk of Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI), and assembling panels of biomarkers to create a “composite marker.” This review will examine the current biomarkers for ovarian cancer and their comparison to ongoing research performed to better diagnose early-onset ovarian cancer.