Task Force Continues to Say “No” to Ovarian Cancer Screening

In February 2018, The US Preventive Services Task Force (USPSTF) published its updated ovarian cancer screening recommendation and continues to recommend against routine screening for ovarian cancer in women who are not at high risk of developing the disease.

In the United States, there are approximately 14,000 deaths/year due to ovarian cancer.  It is the fifth most common cause of cancer deaths in women, and the most common cause of death from gynecological cancer.  Because of these factors, it would be advantageous to have a reliable ovarian cancer screening test applicable to all women. 

The screening tests that were evaluated were transvaginal ultrasound, serum testing for the tumor marker cancer antigen 125 (CA-125) and a combination of both.  The findings in patients without high risk did not show a reduction of ovarian cancer mortality.  Findings indicated a low positive predictive value for these tests in asymptomatic, low-risk women and most women with a positive screening test did not have ovarian cancer.  The many false positive results can lead to unnecessary surgery in women who do not have cancer.

The report made it clear that these recommendations do not apply to women with family history of ovarian or breast cancer or those with known genetic abnormalities which put them at higher risk for the disease.  The recommendation for these patients is referral for genetic counseling, and, if indicated, genetic testing and appropriate follow-up.