Ovarian Cancer Screening Still Ineffective, Not Recommended: Panel
TUESDAY, Feb. 13, 2018 -- Screening for ovarian cancer is not recommended for women with no signs or symptoms of the disease, newly released guidelines from the U.S. Preventive Services Task Force say.
That represents no change in advice from the 2012 guidelines or the task force's draft recommendations issued in the summer of 2017.
"Evidence shows that current screening methods do not prevent women from dying of ovarian cancer and that screening can lead to unnecessary surgery in women without cancer," task force member Dr. Michael Barry said in a task force news release. He's a professor of medicine at Harvard Medical School and a director of the Informed Medical Decisions Program at Massachusetts General Hospital.
No major U.S. medical or public health organization recommends screening for ovarian cancer.
However, the task force recommendation does not apply to women at high risk for ovarian cancer. That includes those with a BRCA gene mutation that is associated with hereditary breast and ovarian cancer.
Ovarian cancer is difficult to detect because it often causes no signs or symptoms in the early stages. Also, many symptoms are vague and similar to those of other health problems. This means that the disease is often diagnosed in the late stages, when it is harder to treat.
However, results from screening tests could prompt a woman to have surgery to remove one or both ovaries when those results could be so-called "false positive." That means the tests indicate the woman has cancer when, in fact, she does not.
Dr. Stephanie Blank, a professor of gynecologic oncology at the Icahn School of Medicine at Mount Sinai in New York City, said she generally agrees with the task force recommendations "because we do not have an effective screening test."
However, she said, "because screening for ovarian cancer is not effective, it is extremely important that women be aware of the symptoms of ovarian cancer and advocate for themselves."
"A woman who believes she is at increased genetic risk for cancer should discuss this with her doctor, and together they can decide whether genetic testing or screening is appropriate," she said.
"A woman who really wants ovarian cancer screening and does not have an indication for it or any symptoms would have to convince her doctor to order the tests," Blank said. "If they are ordered, sometimes they will be covered [by insurance] and sometimes they will not."
However, "if a woman has symptoms of ovarian cancer -- bloating, trouble eating, pelvic or abdominal pain, urinary frequency -- she should demand this testing!" she said.
Besides its recommendation on who should or should not be screened, the task force "is calling for research to find better screening tests and treatments that can help reduce the number of women who die from ovarian cancer," said task force member Dr. Chien-Wen Tseng. She's chair of health services and quality research at the University of Hawaii School of Medicine.
The task force is an independent, volunteer panel of national experts in prevention and evidence-based medicine.
Its guidelines on ovarian cancer screening were published online Feb. 13 in the Journal of the American Medical Association.
The American Cancer Society has more on ovarian cancer.
Posted: February 2018