Ovarian Cancer Screening May Be Leading to Overtreatment

BRIELLE URCIUOLI
Friday, July 21, 2017
Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
Ovarian Cancer Screening May Be Leading to Overtreatment
The United States Preventive Services Task Force (USPSTF) is holding to its previous recommendations that asymptomatic women should not be screened for ovarian cancer, according to a drafted recommendation statement released earlier in the week, which gave ovarian cancer screening a grade D, meaning that it discouraged the practice and has “moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”

Ovarian cancer is the fifth most common cause of cancer-related death in the United States, and is typically diagnosed at a later stage. However, the USPSTF noted, “The positive predictive value of screening for ovarian cancer is low, and most women with a positive screening test do not have ovarian cancer.”

Symptoms of the disease, which often present themselves in the later disease states, are nonspecific to ovarian cancer and can signify a number of other maladies in the abdomen area. This would make it even harder for health care practitioners to determine who should be screened.

Further, the USPSTF cited evidence that screening for women who exhibit no signs or symptoms of ovarian cancer may do more harm than good. Testing with a transvaginal ultrasound or serum tumor marker antigen (CA)-125 was found to have no impact on the number of deaths from the disease. Frequent testing may also bring about false positive, leading to unnecessary surgery or treatment for women who never had ovarian cancer in the first place.

“The USPSTF concludes that there is at least moderate certainty that the harms of screening for ovarian cancer outweigh the benefits,” they said in a release.

However, these recommendations do not apply to women who have certain genetic mutations that increase their risk of developing ovarian cancer, such as BRCA1, BRCA2, Lynch syndrome, Li-Fraumeni syndrome and Peutz-Jeghers syndrome, or those who have had a family history of ovarian cancer. Screening for these women is recommended.

More studies are needed on the outcomes of asymptomatic women who undergo screening for ovarian cancer, according to the USPSTF, who also mentioned that it is highly important that researchers and professionals in the field develop better, and more accurate testing strategies for ovarian cancer. These should be “highly specific” the statement said, and should also minimize the chances of producing false-negatives.

New screenings could save lives.

“Given that most cases of ovarian cancer are diagnosed in later stages, when associated mortality is high, further research to identify new screening strategies that could accurately detect ovarian cancer earlier at a point when outcomes are improved,” the USPSTF said.

Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
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