Task Force Reaffirms Recommendation against Ovarian Cancer Screening
Women at average risk of ovarian cancer should not be screened for the disease, the U.S. Preventive Services Task Force (USPSTF) has reaffirmed. Published in the Annals of Internal Medicine on September 11, the latest USPSTF clinical guideline does not apply to women who have symptoms of ovarian cancer or who have genetic mutations that increase their risk of ovarian cancer. Although available evidence does not show with absolute certainty whether the balance of benefits and harms of ovarian cancer screening differ for women with a family history of ovarian cancer, the USPSTF found no reason to believe that such women would necessarily benefit.
In 2008, the USPSTF commissioned the first review of the literature since its last recommendation on ovarian cancer screening in 2004. This review was extended through 2011 to consider the latest evidence from several randomized controlled trials, including results from the NCI-sponsored Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.
The review focused on two screening methods, transvaginal ultrasound and serum CA-125 testing, and found that screening not only failed to reduce ovarian cancer deaths but could also cause harm. For instance, the USPSTF noted, in the PLCO trial, "nearly 21 major complications occurred per 100 surgical procedures done on the basis of false-positive screening results." The USPSTF thus concluded that "there is at least moderate certainty that the harms of screening for ovarian cancer outweigh the benefits."
The USPSTF recommendation aligns with those of the American Cancer Society and the American Congress of Obstetricians and Gynecologists, neither of which recommend routine ovarian cancer screening for women of average risk without symptoms.