Women who do not have an increased risk for ovarian cancer should not undergo screening tests for the disease, according to new recommendations released April 10 by a leading U.S. government panel.
The U.S. Preventive Services Task Force said that ovarian cancer screening, like blood tests and transvaginal ultrasounds, has more risks, such as false positive tests and unnecessary surgeries, than benefits, according to a draft of recommendations posted on the task force website for public comment.
The panel said that while ovarian cancer has a high death rate, causing more deaths than any other type of female reproductive cancer, the prevalence of the disease is low, with an average incidence rate of 13 cases per 100,000 women, therefore most women who have a positive screening test would later find out that the result is a false-positive and that they actually do not have the disease.
"Currently, the task force does not recommend screening for ovarian cancer," Dr. David Grossman, a member of the task force and senior investigator with Group Health Research Institute in Seattle said, according to HealthDay News. "The tests that we have, unfortunately, just aren't very accurate and, with a lot of false positives, a lot of women get harmed with unnecessary biopsies and surgeries."
The latest recommendations reiterate the health panel’s 2004 recommendations, also advising against screening for ovarian cancer. The panel noted that the current recommendations do not apply to women with known genetic mutations, like versions of the BRCA1 and BRCA2 genes that increase their risk of ovarian cancer.
The Task Force said that current two screening test for ovarian cancer like a blood test to identify the tumor marker CA-125 and a transvaginal ultrasound do not reduce deaths from the disease.
Findings from a large study of more than 78,000 women in 2011 found that deaths from women diagnosed with ovarian cancer did not differ between women who were randomly assigned to receive a blood test plus the ultrasound and women not assigned to screening.
Additionally, researchers found that about 10 percent of the women screened had a false-positive, resulting in one third of those women to have an ovary removed unnecessarily.
Another Japanese study in 2008 estimated that 33 surgeries that confirm the diagnosis of ovarian cancer suggested by screening tests were needed to diagnose one case of the disease detected by screening.
Preliminary data from an ongoing UK trial found false-positive results in about 10 percent of women, and half of those had surgery and 4 percent of those who had surgery had experience a major complication from the operation.
Experts say that ovarian cancer screening tests, like many other screening tests are not effective, potentially dangerous and expensive and doctors perform them because women demand it. They say that the tests provide people with a false sense of security, and create a lot of false positives, which ultimately result in many unnecessary surgeries.
The panel’s recommendations are in line with recommendations from the American Congress of Obstetricians and Gynecologists, which advises against screening for women without symptoms of the condition and the American Cancer Society that recommends screening only for women who have a heighten risk for ovarian cancer or have persistent symptoms.