The United States Preventive Services Task Force has recommended against routine screening with ultrasounds or blood tests for ovarian cancer in asymptomatic women at average risk for the disease.
The reason is simple – these tests are not effective screening.
“There is no existing method of screening for ovarian cancer that is effective in reducing deaths,” Dr. Virginia Moyer, the chairwoman of the expert panel, said in a statement from the group, the United States Preventive Services Task Force. “In fact, a high percentage of women who undergo screening experience false-positive test results and consequently may be subjected to unnecessary harms, such as major surgery.”Yes, there is ultrasound and CA125. But doing these tests in healthy women without symptoms and at average risk causes more problems than it prevents, and most importantly, it does not prevent deaths from ovarian cancer.
Screening is recommended for women who carry genetic mutations that increase their risk of ovarian cancer (such as BRCA or MLH1 mutations), although its impact is still not entirely certain even in this group. More effective in this group is prevention by prophylactically removing the ovaries and fallopian tubes, which will prevent 95% of the ovarian cancers that occur in these women.
While ultrasound has no role in routine screening for ovarian cancer, it remains an important diagnostic tool when women present with symptoms that could be signs of ovarian cancer – bloating, abdominal pain, decreased appetite or early fullness after eating and new onset urgency and frequency of urination not due to other causes such as a UTI. Of course, almost all of the time these symptoms will not be due to ovarian cancer, but it’s important to rule it out.
We May Not Have Effective Screening, But We Do Have Effective Prevention for Ovarian Cancer
What does prevent ovarian cancer is birth control pills. Women who use the pill for as little as 1-2 years will see a 22% reduction in risk, and in long term users get a 60% reduction in risk. Although protection wanes with time, it persists as long as 30 years after stopping the pill. It is estimated that birth control pills have prevented over 100,000 deaths from ovarian cancer to date. (Not to mention pregnancy prevention and other health benefits.)
Users of Depo-Provera may get a similar reduction in risk as pill users do. In addition, tubal ligation may also reduce ovarian cancer risks. Studies are underway in high risk women to see if removal of all or part of the fallopian tube is effective as removal of the ovaries.
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