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[Correspondence] Ovarian cancer screening: UKCTOCS trial

Screening that is able to detect epithelial ovarian carcinoma at a truly curable, early stage would be a major breakthrough. The updated UKCTOCS study provides a glimmer of hope.1,2 Before such a costly screening programme is made routine, we have to be certain that the results cannot be attributed to other factors. Two anomalies in the study need explanation. Why was the beneficial effect only seen late and why was ultrasound alone, contrary to expectation, as effective as multimodality screening? Possible explanations for the small improvement reported are that screening mainly detected, at an earlier stage, the less aggressive, less common, low grade cancers (ie, an effect of tumour biology) and, more relevant in our opinion, a preventive effect of non-cancerous surgeries done as the result of false positive screenings.