Should You Get Screened for Ovarian Cancer?

A new recommendation from the U.S. Preventive Services Task Force, an independent group of national experts, says that most women should not get routinely screened for the fifth-leading cause of cancer-related deaths among women: ovarian cancer.

Why? It turns out that regular screenings do not reduce the number of deaths from ovarian cancer in the general population, and can actually do more harm than good, according to the findings of a 13-year study which followed 78,216 women, half of whom were screened annually.

Although the task force made the same recommendation in 2004, many women are still screened on an annual basis, hoping that it will catch ovarian cancer early on and potentially save their lives. After all, the American Cancer Society estimates about 15,500 women will die of ovarian cancer this year.

“Too many women are dying needlessly from ovarian cancer,” says radiologist Margaret Cuomo, MD, author of the upcoming A World Without Cancer (available this fall) and sister of New York Governor Andrew Cuomo. So how can you take preventative measures in light of the new recommendations? Here, Cuomo weighs in:

Why don’t regular ovarian cancer screenings reduce the number of related deaths?
Currently, the screening methods for ovarian cancer include a blood test called CA-125 and transvaginal ultrasounds. And they are far from perfect, says Cuomo. Low-risk women who regularly undergo blood tests and transvaginal ultrasounds generally aren’t diagnosed any earlier than are women who are not screened annually. About 72% of the cancers that are found through annual screenings are already in the late stage of diagnosis, according to the study. False negatives are to blame. “There’s such an urgency for finding that biomarker, that test that will detect ovarian cancer in its earliest stages,” says Cuomo.

What harm could screening do?
It turns out a lot–particularly if your test delivers false-positive results. In the study, about 10 percent of the women who were screened experienced false-positive results, leading a third of those women to undergo unnecessary surgery. Moreover, 15 percent of them experienced at least one serious complication from that surgery. According to Cuomo, blood tests can deliver false-positive results in women in pregnant women or those with uterine fibroids, polycystic ovary syndrome, or tuberculosis, while transvaginal ultrasounds can return false positives for benign cysts.

Is there anyone who should be regularly screened?
Yes, but only if you’re at high risk. “The tests aren’t perfect, but they are all we have right now,” says Cuomo. “If you are at high risk for ovarian cancer you should use whatever is available to you.” Also, ask your doctor about screening if you experience any symptoms of ovarian cancer, such as irregular vaginal bleeding, persistent urinary or bowel problems, or continued bloating, pelvic, and back pain.

What factors put a woman at high risk for developing ovarian cancer?
Your family history of ovarian cancer—and breast cancer—can greatly influence your ovarian cancer risk. That’s because both cancers can develop from BRCA1 and BRCA2 hereditary gene mutations. (Genetic testing can determine if you have these genetic mutations.) While you can’t change your genes, eating a healthy diet can decrease your risk of ovarian cancer, says Cuomo. Because the chance of developing (and dying) from ovarian cancer is higher in obese women, exercise could also contribute to a reduced risk. Also, as oral contraception use and pregnancy correlate with a lower risk, some experts believe that ovulation could contribute to the development of ovarian cancer.

photo: Photodisc/Photodisc/Thinkstock

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Ovarian Cancer Causes
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