Routine ovarian cancer screening yields only small drop in deaths

The focus should be on better ways to prevent the disease that kills nearly 14,000 American women annually, a new study says.

By Kevin B. O'Reilly, amednews staff. Posted Jan. 5, 2011.

Routine annual screening of women for ovarian cancer using blood and ultrasound tests would not do much to reduce the death toll of the disease, according to a recently published study.

Researchers using data from the National Cancer Institute's Surveillance, Epidemiology and End Results registry and the ongoing United Kingdom Collaborative Trial of Ovarian Cancer Screening ran a computer simulation and found that screening asymptomatic post-menopausal women ages 50 to 85 would reduce mortality by a "modest" 10% to 15%.

"Many early stage ovarian cancers are destined to remain in the early stages for some time, while advanced stage cancers have likely spread rapidly," said the study, by researchers at the Duke Cancer Institute and published online Dec. 13, 2010, in the journal Cancer.

This is why ovarian screening tools, including a blood test for elevated levels of the cancer antigen protein 125 and transvaginal ultrasound imaging, yield a modest reduction in mortality, the study said (www.ncbi.nlm.nih.gov/pubmed/21154918/).

"What this and other studies are telling us is that we will have to do a whole lot more than screening to protect women from this terrible disease," said Laura Havrilesky, MD, lead author of the study and associate professor of gynecologic oncology at Duke University School of Medicine in Durham, N.C. "We need to work harder to find better approaches to screening and also consider the potential value of preventive strategies."

More than 21,000 women in the U.S. are diagnosed each year with ovarian cancer, and nearly 14,000 die of the disease, the American Cancer Society estimates.

An editorial accompanying the article argued that screening could be of greater benefit to women with a family history of ovarian cancer or with mutations in the breast cancer genes, BRCA1 and BRCA2.

"A higher background risk means that a positive screen will be accurate more often, resulting in fewer ultrasound studies and surgeries that yield no cancer," wrote Patricia Hartge, deputy director of the epidemiology and biostatics program at the National Cancer Institute's Division of Cancer Epidemiology and Genetics.

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