USPSTF Recommends Against Screening for Ovarian Cancer in Asymptomatic Women


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“Evidence shows that current screening methods do not prevent women from dying of ovarian cancer and that screening can lead to unnecessary surgery in women without cancer.”
— Michael J. Barry, MD

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THE U.S. PREVENTIVE Services Task Force (USPSTF) recently published a final recommendation statement and evidence summary on screening for ovarian cancer. Based on its review of the evidence, the USPSTF recommends against screening for ovarian cancer in women who do not have any signs or symptoms of the disease. This is a D recommendation. 

Ovarian cancer is difficult to detect, and many women do not show signs or symptoms in the early stages. Further, the symptoms of ovarian cancer are often vague and similar to those of many other health issues—or may even be present in healthy women—which makes it even more difficult to identify ovarian cancer early. As a result, ovarian cancer is often diagnosed at a late stage, when it is more difficult to treat successfully. Unfortunately, current screening tests do not accurately identify whether a woman has, or does not have, ovarian cancer. Therefore, screening may lead to a woman having unnecessary surgery to remove one or both ovaries when she does not have ovarian cancer. 

Michael J. Barry, MD

Michael J. Barry, MD

“The Task Force recommends against screening for ovarian cancer in women who have no signs or symptoms,” said USPSTF member Michael J. Barry, MD, Director of the Informed Medical Decisions Program in the Health Decision Sciences Center at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School. “Evidence shows that current screening methods do not prevent women from dying of ovarian cancer and that screening can lead to unnecessary surgery in women without cancer.” 

High-Risk Exceptions 

CURRENTLY, NO MAJOR U.S. medical or public health organization recommends screening for ovarian cancer. However, it’s important to note that this recommendation does not apply to women who are at high risk for ovarian cancer, such as women with a BRCA gene mutation that is associated with hereditary breast and ovarian cancer syndrome. 

Chien-Wen Tseng, MD, MPH, MSEE

Chien-Wen Tseng, MD, MPH, MSEE

“Ovarian cancer is a devastating disease, and we do not have a good way to identify women with ovarian cancer early enough to treat it effectively,” said USPSTF member Chien-Wen Tseng, MD, MPH, MSEE, Endowed Chair in Health Services and Quality Research at the Hawaii Medical Service Association and Associate Professor and Associate Research Director in the Department of Family Medicine and Community Health at the University of Hawaii John A. Burns School of Medicine. “The Task Force is calling for research to find better screening tests and treatments that can help reduce the number of women who die from ovarian cancer.” 

Consistent With Earlier Recommendations 

THIS FINAL RECOMMENDATION is consistent with the USPSTF’s 2012 final and 2017 draft recommendation statements. This recommendation statement has been published online in The Journal of the American Medical Association,1 as well as on the Task Force website at www.uspreventiveservicestaskforce.org. A draft version of the recommendation statement was available for public comment from July 18 to August 14, 2017. 

The Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. 

TASK FORCE RECOMMENDATION GRADES 

A = The USPSTF recommends the service. There is high certainty the net benefit is substantial. 

B = The USPSTF recommends the service. There is high certainty the net benefit is moderate or there is moderate certainty the net benefit is moderate to substantial. 

C = The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty the net benefit is small. 

D = The USPSTF recommends against the service. There is moderate or high certainty the service has no net benefit or the harms outweigh the benefits. 

I = The USPSTF concludes the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. ■

REFERENCE 

 

 1. U.S. Preventive Services Task Force: Screening for ovarian cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA 319:588-594, 2018.


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