“The working group recommends against screening for ovarian cancer in women who have no signs or symptoms,”, said USPSTF member Michael Barry, M. D., in a press release.(www.uspreventiveservicestaskforce.org) “the Evidence shows that the methods of the present screening does not prevent women from dying of ovarian cancer and that screening can lead to unnecessary surgery in women without cancer.”
According to the working group, it’s important to note that this recommendation does’t apply to women who are at high risk of ovarian cancer, such as women with a BRCA gene mutation that is associated with the hereditary breast and ovarian cancer syndrome.
This last recommendation is consistent with the USPSTF’s 2012 final and the 2017 draft recommendation statements. The AAFP, is the reflection of the task force’s in its own version of the final recommendation of the report.
Currently, no major U.S. medical or public health agency recommends routine screening of ovarian cancer.
the Scope of the Review
The USPSTF commissioned a review of the evidence on ovarian cancer screening update its 2012 final recommendation, which evaluated the advantages and disadvantages of screening in asymptomatic, average-risk women.
the Outcomes of interest were ovarian cancer mortality, quality of life, false-positive rate of test results, the surgery and the rate of surgical complications, and the psychological effects of screening. Any screening approach (for example, transvaginal ultrasound or CA-125 test), which has been evaluated in the trials reviewed has been included.
The working group has identified three good-quality studies that have examined how the annual screening for affected asymptomatic women not at high risk for ovarian cancer, and none of them are that screening significantly reduces mortality from ovarian cancer.
The USPSTF also reviewed evidence on the harms of ovarian cancer screening of these and a fourth, fair-quality study reported on quality of life and psychological harms of screening.
Through all of the trials reviewed, the percentage of women who received screening who underwent surgery due to false-positive results ranged from 0.2% to 3.25%. Of this group, 0 percent to 15 percent of participants have experienced major surgical complications.
Response to the Comments of the Public
last summer’s the public consultation period for the draft version of this recommendation, the working group has received feedback from many commenters were concerned that because ovarian cancer is aggressive, and its symptoms often appear at later stages, screening tests that can detect this type of cancer early should be recommended.
The USPSTF responded that, “the evidence shows that the tests currently available are not capable of detecting ovarian cancer), and can lead to damage causing healthy women to undergo surgical removal of their ovaries no cancer is present.”
Other stakeholders on the draft declaration asked for clarification on what factors put a woman at high risk for cancer of the ovary (and, therefore, are not covered by this recommendation). In response, the working group has revised its final statement to clarify the role of family history of ovarian cancer risk, and describe the symptoms of the disease.
“Women with a family history of ovarian or breast cancer or symptoms should discuss with their health care provider,” the final recommendation is noted.
The USPSTF has further explained that it included primary peritoneal cancer, in its finding of cancer of the ovary, the results — even if this was not the primary end point of the study — because that on the clinical level, the two types of cancer are diagnosed and treated as a disease. The task force has also stated that its finding of results considered to be reports to both prevalent and incident cases of ovarian cancer, because the screening will detect both.
“the Ovarian cancer is a devastating disease, and we don’t have a good way to identify women with ovarian cancer at a stage early enough to treat them effectively,”, said USPSTF member of Dog-Tseng Wen, M. D., M. P. H., M. S. E. E., in the press release. “The working group is to call for research to find better screening tests and treatments that can help to reduce the number of women who die of ovarian cancer.”
Related AAFP News CoverageAAFP Recommends Against Pelvic Exams in Asymptomatic Women with the Orientation Differs From the USPSTF Final Recommendation (4/25/2017)
USPSTF Final Recommendation Evidence is Lacking on Routine Gynecological Screening Pelvic Examinations(3/8/2017)
From American Family physician that the Doctors, Women Need to Know About Screening for Ovarian Cancer(6/3/2016)