During the last year, population screening trials from the USA and Japan have reported on the effectiveness of transvaginal ultrasound screening in the early detection of ovarian cancer. Although the data are not from randomized trials, it is consistent with an impact of screening on mortality. A randomized control trial to definitively answer this question is now underway in the UK. This study also addresses the issues of target population, compliance, health economics and physical and psychological morbidity of screening.