USPSTF Recommends Against Routine Screening For Ovarian Cancer

Confirming the position taken in draft guidelines released in April, the US Preventive Services Task Force (USPSTF) recommended that women do not routinely get screened for ovarian cancer if they are not at high risk for the disease. The panel found that such screening can put women at increased risk of unnecessary harm, such as major surgery.

The USPSTF, an independent volunteer panel of non-government experts in prevention and evidence-based medicine, is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, and nurses). The USPSTF makes recommendations about the effectiveness of specific clinical preventive services for patients without related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.

The Recommendation Statement was published Sept. 10, 2012 in the Annals of Internal Medicine, and reaffirms the USPSTF findings from 2004, in which they recommended against screening for ovarian cancer, citing lack of evidence that routine screening with CA-125 and transvaginal ultrasound reduces deaths from the disease.

Importantly, this recommendation does not apply to women at high risk for the disease, either because of family or personal history, or other risk factors like BRCA1 or 2 genetic mutations. The USPSTF recommends that “women with an increased-risk family history should be considered for genetic counseling to further evaluate their potential risks.”

The Society of Gynecologic Oncology, which endorsed the USPSTF guidelines on Sept. 11, said in a statement:  “Genetic testing and counseling can help determine whether a woman is at higher risk for developing ovarian cancer. Risk factors include family history of ovarian cancer, mutations in genes known to increase risk (BRCA1 and BRCA2), diagnosis of pre-menopausal breast cancer and personal history of Lynch syndrome or inheritance of genetic mutations associated with Lynch syndrome. Women with family histories of the following additional cancers should also consider genetic counseling: colon, endometrial, fallopian tube and peritoneal cancer.”

Read more in the New York Times, Washington Post, and Health Day.