Earlier this month, the U.S. Preventive Services Task Force reaffirmed its previous recommendation that most women don’t need routine ovarian cancer screening.
The agency looked at recent evidence to see if anything new has been published that might alter its 2004 recommendation and concluded, once again, that annual screening is likely to do more harm than good in women who do not have any symptoms, genetic markers, or other increased ovarian cancer risk factors.
The reason? Studies have shown that the current methods for regular screening — transvaginal ultrasonography or serum CA-125 testing — are not effective in reducing ovarian cancer deaths in women without increased risk.
For many women, these tests will produce incorrect results suggesting cancer, causing women to undergo unnecessary surgery in order to get confirmation. Surgery can include the removal of a healthy ovary and associated harms such as infections or blood clots.
The recommendation does not apply to women with known genetic mutations that increase their risk for ovarian cancer. The Taskforce has also produced this fact sheet that explains the rationale for the recommendation and includes information to help you decide if you should be screened.
Groups Agree with Recommendation, But Screening Still Common
The Taskforce is not alone in its findings. The American Congress of Obstetricians and Gynecologists does not recommend screening for ovarian cancer in asymptomatic women. And the American Cancer Society has stated that there is no screening test proven to be effective and accurate in early detection.
Despite the USPSTF’s 2004 recommendation against routine screening, many physicians still provide it, likely misunderstanding its utility. According to the The New York Times, based on a 2008 survey:
But some doctors continue to recommend screening anyway, and patients request it, clinging to the mistaken belief that the tests can somehow find the disease early enough to save lives. A report published in February in Annals of Internal Medicine, based on a survey of 1,088 doctors, said that about a third of them believed the screening was effective and that many routinely offered it to patients.
Research on Screening Continues
In addition to finding no new evidence supporting annual screening, and additional evidence on harms, the Task Force also notes that research continues on specific methods of screening and screening in general.
“The main gap in our knowledge,” write Taskforce members, “remains the uncertain ability to offer effective treatment of cancer at an early stage to improve the ultimate outcome.”
The recommendation, then, might change in the future if better evidence is found that screening can reduce deaths or if forms of screening are devised that can be shown to affect survival rates.
Cara Tenenbaum of the Ovarian Cancer National Alliance emphasizes that more research is needed to find better methods of screening: “The task force’s recommendation underscores how badly we need an effective screening test for ovarian cancer. Ovarian cancer is the deadliest gynecologic cancer because it often isn’t detected until the disease is in an advanced state.”
CDC Campaign Advises Women to Pay Attention to Physical Changes
The most common symptoms of ovarian cancer include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and urinary symptoms, such as frequent or urgent urination. These symptoms could apply to a range of health issues — most of the time, they’re caused by other, less serious health issues.
The Centers for Disease Control has created an Inside Knowledge campaign to raise awareness about gynecologic cancers. The campaigns includes fact sheets and posters in Spanish and English, and radio and television public service ads featuring women discussing the symptoms that led them to visit their health care provider. The ad below features writer and performer Jenny Allen.
Plus: For more links to news stories and analysis, read the Women’s Health Policy Report.