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USPSTF Finds Harm Outweighs Benefits of Ovarian Cancer Screening for Asymptomatic Women

NEW YORK (360Dx) – With at least a moderate level of certainty, harm outweighs the benefits of screening for ovarian cancer in asymptomatic women who are not at high risk, according to the US Preventive Services Task Force, a panel of experts that makes recommendations on clinical preventive services to primary care clinicians.

In a draft recommendation statement requesting public comment, the USPSTF said it has found "adequate evidence" that harm includes false-positive screening results that can lead to surgical interventions in women who do not have cancer.

"Depending on the type of screening test used, the magnitude of harm ranges from moderate to substantial, and reflects the risk of unnecessary surgery," the task force said in its draft statement.

USPSTF noted that it has found that "adequate evidence that screening with transvaginal ultrasound, testing for the serum tumor marker cancer antigen CA–125, or a combination of both, does not reduce the number of deaths from ovarian cancer in women."

It said that to address these issues, further research is needed to identify new screening strategies that could "accurately detect ovarian cancer earlier at a point when outcomes could be improved."

Most cases of ovarian cancer are diagnosed at later stages, when associated mortality is high, it said.

New screening strategies should minimize false-positive results and be highly specific, the USPSTF said, adding that studies are also needed to evaluate the benefits and harms of using screening strategies in asymptomatic women not at increased risk for ovarian cancer.

The age-adjusted incidence of ovarian cancer from 2010 to 2014 was 11.4 cases per 100,000 women per year, the USPSTF said, citing information from the Centers for Disease Control and Prevention. It is the fifth-most common cause of cancer death among women, according to the National Cancer Institute.

The USPSTF draft statement applies to asymptomatic women, but not to women who are known carriers of genetic mutations that substantially increase their risk for ovarian cancer, including BRCA1 and BRCA2 gene mutations, and Lynch, Li-Fraumeni, and Peutz-Jeghers syndromes.

Its final recommendation statement will be developed after a review of feedback and will include both a research plan and evidence review as a basis of the statement.

This opportunity for public comment expires on August 14.