The Case For and Against Ovarian Cancer Screenings

The United State Preventative Services Task Force recently reaffirmed their recommendation against routine screenings for ovarian cancer. What does this decision mean for you and your health?

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Ovarian cancer is considered a “silent killer” because many of its victims are not diagnosed until it has already reached an advanced stage. Its preliminary symptoms are nonspecific and are very commonly missed and misdiagnosed by doctors everywhere. However, does it make sense for doctors to screen every asymptomatic postmenopausal woman in the United States for this deadly disease? A panel of experts say no.

The United States Preventative Services Task Force (USPSTF) is a respected panel of physicians that review “a broad range of clinical preventative health care services,” which include screenings for cancers. This week, they reaffirmed their 2004 position against regular screening for ovarian cancer – citing that it may cause more harm than good.

Ovarian cancer is the ninth leading cause of death for women, but the fifth leading cause of cancer death for women. The American Cancer Society estimates that 22,280 women will receive a new diagnosis of ovarian cancer and 15,500 women will die from this cancer in 2012. On The Dr. Oz Show, we’ve discussed the warning signs of ovarian cancer and the three tests that can save your life, which are listed below.

The experts reviewed research on the effects of regularly screening postmenopausal women. One major study from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial screened more than 28,000 women between the ages of 55 to 74 years old with no symptoms. The researchers screened them for ovarian cancer with either a transvaginal ultrasound, a blood test for cancer marker CA-125, or both. Those with signs that were concerning for ovarian cancer received surgical biopsies of their ovaries to test for cancer. Less than a third of women who received biopsies after getting positive testing results actually had an invasive cancer. This means most women had received unnecessary biopsies due to false positive results with current screening technology.

Why so many false positives? One reason includes the tests’ ability to find more common benign conditions that happen to look like cancer, like ovarian cysts, non-dangerous tumors, and normal variations. Normal healthy women have a wide range of already-existing CA-125 levels in their body, which makes it difficult for experts to agree on a level of CA-125 in the blood that would definitely indicate cancer without inadvertently excluding women with existing cancer.

If every post-menopausal woman, asymptomatic or symptomatic, received regular ovarian cancer screenings with currently available methods, the experts on from the USPSTF fear that a large number of women would undergo unnecessary anxiety and invasive biopsy procedures.

However, the threat of this deadly cancer still exists. While new screening technologies for ovarian cancer are developed, you can take several steps to reduce your risk of ovarian cancer. Taking birth control pills for five years can reduce a woman’s risk of ovarian cancer by 50%. Breastfeeding, tubal ligation and hysterectomy (removal of the uterus) also reduce the risk of ovarian cancer. Asking family members about cancer history, including breast and ovarian cancer, is also a major step toward prevention. There are several genes that are linked to these cancers and would increase your risk.

Concerned about ovarian cancer? Despite the USPSTF’s new findings, you should still be vigilant and listen to your body for the following ovarian cancer warning signs:

  1. Bloating or increased abdominal size, which occurs almost every day and persists for at least 2 weeks.
  2. Pelvic or abdominal pain, which occurs on most days for 2-3 weeks.
  3. Difficulty eating or early satiety (feeling full earlier); cancer affects the ability of the intestines to hold ingested food.
  4. Going to the bathroom more often than usual may also be a sign of a growing cancer, though it is more commonly caused by urinary tract infections.
  5. A personal or family history of cancer – especially breast, ovarian or colon cancer – should add to your concern for developing cancer in the future.

Use Doctor Oz’s Ovarian Cancer One-Sheet to track any symptoms you may be experiencing. If you have symptoms one through four, see your physician, who can provide a full physical exam and administer one or more of the following three ovarian cancer tests.

Ovarian Cancer Screening Tests:

  1. Transvaginal Ultrasound: This test allows the doctor to see a better picture of your ovaries. It would show if your ovaries are larger than they should be. If you are premenopausal, your ovaries should each be the size of a walnut; after menopause, they typically shrink down to the size of an almond.
  2. Recto-vaginal exam: This allows the physician to access and feel the ovaries more easily because the ovaries are more posteriorly located.
  3. Blood test for CA-125: This test measures a protein that ovarian cancer cells secrete into the bloodstream; elevated levels may indicate an ovarian cancer.

For more information on ovarian cancer, including information on how to prevent this silent killer, visit Doctor Oz’s Ovarian Cancer Center. You can also find out how to reduce your risk for ovarian cancer here.