Healthy women shouldn’t take screening tests to spot ovarian cancer, a U.S. panel said, updating and reaffirming its 2004 recommendation against the procedure.
The U.S. Preventive Services Task Force reviewed studies that have been conducted since its earlier recommendation and found that ovarian cancer screening using transvaginal ultrasound and a blood test called CA-125 doesn’t reduce the number of deaths from the disease, according to the recommendation published yesterday in the Annals of Internal Medicine. In particular, a U.S. study last year of 78,216 women found that those who were screened didn’t have a lower death rate from the cancer than women who weren’t tested.
“This is very high-quality evidence, it very strongly supports not screening,” said Virginia Moyer, chairwoman of the task force and a pediatrician at Baylor College of Medicine in Houston. “There is a risk of serious harm associated with screening.”
The group in May advised against using a common screening test for prostate cancer, called prostate specific antigen. The risk of excessive treatment from false positive results with the PSA test isn’t worth the risk and the screening shouldn’t be used to diagnose the disease, the group said. In November 2009, the advisory group of doctors said annual mammograms for women in their 40s have more risks than benefits, and women at average risk of breast cancer should use screening every two years once they turn 50.
Ovarian cancer will be diagnosed in 22,280 American women this year, and 15,500 patients will die from the disease, according to the American Cancer Society. It is the fifth-most common cause of cancer deaths in women, the group said.
“There is currently no sufficiently accurate screening test proven to be effective in the early detection of ovarian cancer,” the Atlanta-based organization said in a fact sheet on its website.
The case against ovarian cancer screening is particularly clear, Moyer said in a telephone interview. By the time such a tumor is visible with ultrasound, it is very advanced, she said.
Meanwhile, regardless of the testing method, the “number of false positives is stunningly high,” she said. As for the blood test, CA-125 levels are elevated for many other reasons, including pregnancy and liver problems, she said.
Once an ovarian cancer test comes back positive, “the only way to find out if there is something real going on is to do something very invasive like surgery, which in and of itself carries substantial risk,” Moyer said.
In the previous U.S. study, 1 in 10 women who were screened got a false positive result and 1 in 3 of those had their ovaries removed during surgery.
“The problem is that we want to do something,” Moyer said. In ovarian cancer screening, “unfortunately what we choose to do does more harm than good.”