Task Force rules ovarian cancer screening does not outweigh the risks

The U.S. Preventive Task Force recommends against screening

The U.S. Preventive Task Force on Monday released their recommendation against ovarian cancer screening rating it with a grade D.

The U.S. Preventive Services Task Force (USPSTF) grades its recommendations according to one of five classifications (A, B, C, D, I) reflecting the strength of evidence and magnitude of net benefit (benefits minus harms).

The grade D rating means the USPSTF recommends against routinely providing of the service to asymptomatic patients and that the task force found at least fair evidence that the service is ineffective or that harms outweigh benefits.

The screening had been found not to reduce the number of ovarian cancer deaths.

The typical screening looked at was transvaginal ultrasonography or a blood test that looks for the tumor marker CA-125. Blood test cost is under a hundred dollars while the ultrasonography can cost between two and three hundred dollars.

These recommendations apply to women who have no signs of the disease and do not carry the genetic mutations like BRCA1 and BRCA2.

According to the recommendation statement adequate evidence shows that screening for ovarian cancer can lead to important harms, including major surgical interventions in women who do not have cancer.

The screening for ovarian cancer which greatly depends on the predominance of the disease is low and most women with a positive screening test will have a false positive result that can lead to unnecessary harm including major surgical interventions in women who do not have cancer states USPSTF.

The task force recommendation on screening may not be wrong. A 18 year old study by the National Cancer Institute found that widespread screening for ovarian cancer does not save lives but does initiate many women to have needless surgery that have avoidable complications.

That study had examined the same two tests as the task force and found while they may be helpful for women at high risk for the disease there value for women for a long time have been in doubt.

Dr. Beth Karlan, MD, Director, Women’s Cancer Programamuel Oschin Comprehensive Cancer Institute Director, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Director, Gilda Radner Hereditary Cancer Program, Board of Governors Chair in Gynecologic Oncology, stated “ Every professional group says no screening for average-risk women,’ as reported by the Los Angeles Times. Dr. Karlan says she will continue to tell her patients who are not at high risk not to be screened.

Why is there a problem with the tests? Ultrasound help doctors see unusual growth in the ovaries but cannot determine if it is a benign cyst or malignant tumor. Growths are removed by surgery but the surgery comes with complications.

The blood tests are not specific especially when the cancer is in the early stages. Ovary cancer cells emit the CA-125 protein into the blood. However, in over half the women with early stage ovarian cancer there is not of a marker to sound off an alarm. Another problem is that high levels of CA-125 do not mean ovarian cancer. Endometriosis, fibroid's and other cancers can cause a spike in levels.

The National Cancer Institute estimates that this year there will be 22,280 new cases of ovarian cancer and it will cause 15,500 deaths.

The American Cancer Society website lists the risk factors for ovarian cancer.