In June, the Journal of the American Medical Association (JAMA) published an article addressing a recently updated recommendation by the U.S. Preventive Services Task Force. The title of the article was “Screening Women for Ovarian Cancer Still Does More Harm Than Good.”
Unfortunately, even though the title is accurate, JAMA soft-pedaled the information so much that the story didn’t carry the impact it should have. Because when they’re not couched by mealy-mouthed medical journalism, the facts about ovarian cancer screening are downright damning.
You see, this isn’t the first time the U.S. Preventive Services Task Force (USPSTF) has found problems with ovarian cancer screening. It had already received “grade D” recommendations three times before—in 1996, 2004, and 2008.
Primarily because the two methods used—transvaginal ultrasonography (TVU) and a serum tumor marker called cancer antigen 125 (CA-125)—continually fail to accurately detect ovarian cancer in women.
But of course these screenings have continued. Wasting time and money, and purveying false hopes for prevention, with no improvement in their “grades” for 15 years.
And once again, this April, the USPSTF cited continuing evidence that ovarian cancer screening has little effect on reducing mortality rates. Moreover, it actually increases risk of harm.
Among the clinical trials the task force evaluated, the evidence was clear. Screening did not reduce the rate of ovarian cancer deaths. There is also a high rate of false positives. Which often lead to dangerous, debilitating, and completely unnecessary surgery.
Even monitoring women at high risk of ovarian cancer didn’t reduce the death rate. (Women at high risk of developing ovarian cancer are those with BRCA genetic mutations, Lynch syndrome, a history of premenopausal breast cancer, or a strong family history of breast and ovarian cancer.)
Despite the dismal track record, cancer experts still hold out the usual hope that they’ll find different biomarkers. Ones that will help them finally develop accurate, cost-effective ovarian cancer screening.
But if these so-called experts actually understood human patho-physiology, they would realize that biomarker levels only become elevated once the disease has reached an advanced stage. Too late to actually help ovarian cancer patients. But this is the typical NCI approach of locking the barn door after the four horses of the apocalypse are already on the loose.
But admitting that fact might mean no more research funding for another misbegotten and fruitless decades-long battle for more “biomarkers” in the ongoing “War on Cancer.”
The bottom line is that there is still no scientific justification for routinely screening women for ovarian cancer. In fact, as the headline of the JAMA article plainly states, it does more harm than good.
“Screening Women for Ovarian Cancer Still Does More Harm than Good,” JAMA 2012; 307(23): 2,474-2,475