Ovarian Cancer Screening
Posted 9/15/2012
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Since both are women's cancers, ovarian cancer often feels like a close cousin to breast cancer. I remember when we were told that women who had breast cancer were at a higher risk of developing ovarian cancer. That statement sent me to a GYN oncologist not long after my first breast cancer; I spoke with him about a possible oopherectomy and he, not surprisingly, refused to do it. As we know, surgeons do not like to take out healthy organs. He did reassure me, to some extent, and shortly thereafter, information about the BRCA mutations came out. At that point, it became clear that there was not a general increased risk, but, rather a risk for women who carried the mutation.
Ovarian cancer is often a bad disease--actually, let me rephrase that. Cancer, of any kind, is always a bad disease. But ovarian cancer is often not diagnosed until a later stage, and the treatment options are expanding, but still fewer than they are for breast cancer. Diagnosis is very difficult, and there has long been a wish for a useful screening test. Every now and then, there is hype in the media about a test, and it always turns out to be less than very good.
This is an article from the Huffington Post that discusses some recent statements and tests: bottom line is that the risks outweigh the benefits of screening, and there is still not a useful screening test. After this beginning and a link, I will also post a link to the study itself.
New Ovarian Cancer Screening Guidelines Highlight Lack Of Options For Women
Not only is there still not a reliable routine test for ovarian cancer, the existing options may do more harm than good, according to a major government health panel.
The new U.S. Preventive Services Task Force recommendation, issued Monday, reaffirms its 2004 stance on ovarian cancer screening and highlights the lack of effective early detection options for women.
"Screening for ovarian cancer is not a good use of a patient's or a doctor's time or resources," Dr. Virginia Moyer, a member of the task force, told The Huffington Post. "It does not improve mortality, and no major organization recommends it."
In 2012, more than 22,000 women in the U.S. will receive a new diagnosis for ovarian cancer,
according to the American Cancer Society. The disease is relatively uncommon -- a woman's risk of developing ovarian cancer during her lifetime is about 1 in 71 -- but it is dangerous. In the U.S., it is the fifth-leading cause of
cancer death in women, behind cancer of the lung, breast, colon and rectum and pancreas.
"Ovarian cancer is worth screening for because it is very deadly," said Dr. Stephanie Blank, an OB-GYN and associate professor with the NYU Langone Medical Center. Blank said outcomes would be improved if doctors could detect the disease earlier. However, the current screening methods are problematic, in part because they often lead to false positives, Blank explained.
In devising the new recommendations, the task force reviewed recent studies looking at the efficacy of the two most common tests used to screen for ovarian cancer: transvaginal ultrasound and the CA-125 blood test. The former, in which an ultrasound is used to look for masses in the ovaries, had generally been thought to be the more promising method for screening. The CA-125 test is used to check for levels of that protein in the blood, which are higher in women with ovarian cancer.
But neither reduces the number of deaths from ovarian cancer, the new USPSTF recommendation states, and there is "at least moderate certainty" that the harms outweigh the benefits.
http://www.huffingtonpost.com/2012/09/11/ovarian-cancer-screening_n_1871385.html
And, to read the study itself:
http://www.uspreventiveservicestaskforce.org/uspstf/uspsovar.htm
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