Ovarian cancer screenings not recommended as a routine

Sept 2012

By Lena H. Sun, Published: September 10

A federal government task force recommended Monday that women not get routinely screened for ovarian cancer because doing so can put them at increased risk for unnecessary harm, such as major surgery.

The U.S. Preventive Services Task Force, an independent group of national experts, said it continues to discourage screening in women at average risk for ovarian cancer, which has the highest mortality rate of all types of gynecological cancer and is the fifth-leading cause of cancer death among women.

Although the task force made the same recommendation in 2004, the panel’s latest recommendation is based on the largest clinical trial published so far. It confirms previous findings, the task force chairman said.

“It was a pretty definitive study. It confirmed what we thought was the case,” said Virginia Moyer, the panel chair. Half the women in the study were screened with transvaginal ultrasounds and a blood test called CA-125, which is how screening is typically done. The other half of the women were not screened. There were 78,216 women in this trial.

“It made no difference in the outcome,” she said.

But a high percentage of women who undergo screening experience false-positive tests that then require invasive testing, such as major surgery to open up the abdomen and take out the ovary, she said.

“That puts those women at increased risk for being harmed. That’s major surgery.”

She said the task force tries to update its recommendations every five years based on new evidence. Its last recommendation against routine screening for ovarian cancer was issued in 2004. In 2008, review of the literature was commissioned by the task force and revealed no new evidence about the benefits of screening.

The task force did not make a recommendation, Moyer said, because the large clinical trial was underway.

Moyer said screening guidelines by other medical and public health organizations are in line with the panel’s. For example, the American Congress of Obstetricians and Gynecologists does not recommend screening for ovarian cancer in women who are not showing symptoms. Also, the American Cancer Society says there is no screening test proven to be effective and sufficiently accurate in the early detection of the cancer.

Women’s health advocates said the latest recommendation does show that better screening tools need to be developed.

“The important thing to remember is that if women do have symptoms or have a family history of ovarian cancer, they need to see a doctor,” said Pat Goldman, founder of the Ovarian Cancer National Alliance. Symptoms include persistent urinary or bowel changes or pelvic pain, or a feeling of fullness when you haven’t eaten.