Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

USPSTF: Screening for Ovarian Cancer

JAMA; 2018 Feb 13; USPSTF, Grossman, et al

The US Preventive Services Task Force (USPSTF) has issued a recommendation statement for the screening of ovarian cancer. The statement is an update to the 2012 USPSTF recommendation and reviewed the evidence on the benefits and harms of screening for ovarian cancers in asymptomatic women not known to be at high risk for ovarian cancer. The statement is as follows:

  • The USPSTF recommends against screening for ovarian cancer in asymptomatic women.
  • This recommendation applies to asymptomatic women who are not known to have a high-risk hereditary cancer syndrome.

Citation:

US Preventive Services Task Force. Screening for ovarian cancer. US Preventive Services Task Force recommendation statement. JAMA. 2018;319(6):588-594. doi:10.1001/jama.2017.21926.

Commentary:

Most women diagnosed with ovarian cancer are diagnosed at later stages of the disease with low survival rates. Early stages are commonly asymptomatic or have nonspecific symptoms. A screening test that could accurately detect ovarian cancer in these early stages would be most welcome.

Unfortunately, with the available tests, CA-125 and transvaginal ultrasound, this review found no mortality benefit for ovarian cancer screening in low risk women. Furthermore, the high false positive rates with these tests led to unnecessary surgeries (with a 15% rate of major surgical complications in one study) and decreased quality of life due to excess cancer worry.

As the harms far outweigh any benefits, the USPSTF recommendation against ovarian cancer screening seems both warranted and prudent until new strategies or screening modalities have been identified.

—Amy Clouse, MD

Associate Clinical Professor, Sidney Kimmel Medical College, Thomas Jefferson University

Associate Director, Family Medicine Residency Program, Abington-Jefferson Health

Must Reads in Clinical Guidelines

USPSTF: Interventions to Avert Perinatal Depression, JAMA; 2019 Feb 12; US Preventive Services Task Force

ACIP Updates Adult Immunization Schedule, Ann Intern Med; 2019 Feb 5; Kim, Hunter, et al

USPSTF: Interventions to Prevent Child Maltreatment, JAMA; 2018 Nov 27; US Preventive Services Task Force

Cholesterol Guidelines Stress Lifetime Approach, Circulation; ePub 2018 Nov 10; Grundy, et al

USPSTF: Screen Adults for Unhealthy Alcohol Use, JAMA; 2018 Nov 13; Curry, et al