Ovarian cancer is the leading cause of death from a gynecologic malignancy, and there is continual interest whether the general population should be screened for this disease. A recent report has suggested a new blood test testing for early ovarian cancer. Here’s how the media portrayed this:
BY THE TIME MANY WOMEN FIND OUT THEY HAVE OVARIAN CANCER, IT’S TOO LATE.
THAT’S BECAUSE THERE’S NEVER BEEN A REAL SCREENING METHOD TO CATCH THE CANCER EARLY… UNTIL NOW.
MEDICAL REPORTER KATHY FOWLER SHOWS US HOW NEW RESEARCH COULD CHANGE THE FUTURE OF DIAGNOSING THIS DEADLY DISEASE.
A PSA BLOOD TEST HELPS DIAGNOSE PROSTATE CANCER IN MEN. NOW THAT SAME CONCEPT COULD BE USED TO SCREEN FOR OVARIAN CANCER, GIVING WOMEN A FIGHTING CHANCE.
When the media gets hold of the “latest, greatest” test, it tends to slant the facts sensationally. Taking an objective view of screening tests is something that tends to be neglected. First consider the benefits of a screening test – the obvious one is decreased mortality from early detection. In the case of ovarian cancer, there is no conclusive evidence this is the case:
Three randomized controlled trials are in progress to determine whether earlier diagnosis and decreased mortality (compared with no screening) can be achieved. Estimates of the benefits of screening must be considered tentative at best until the results of these studies are available.
One must also the potential risks of screening – which are considerable in ovarian cancer:
Although ovarian cancer is an important cause of cancer death, its incidence and prevalence in the general population are relatively low. The problem of false-positive screening tests becomes critically important in diseases with such a low prevalence. Since a positive screening test for ovarian cancer would probably lead to surgery (either laparoscopy or laparotomy), a large number of healthy women would be undergoing these procedures unnecessarily. These invasive procedures carry immediate physical and psychological morbidity, as well as a small risk for serious complications; they also account for substantial financial costs.
This is why no expert group recommends routine screening for ovarian cancer:
The U.S. Preventive Services Task Force, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the Canadian Task Force on the Periodic Health Examination all recommend against routine screening for ovarian cancer in asymptomatic women.
Until studies show an improvement in mortality – and there are several studies currently pending – this will continue to be the case.
