Don’t screen for ovarian Ca—but do pursue early detection
Consider vigilance by way of a two-step algorithm. The potential is there for you to improve outcomes.
The consensus statement cautions that it is possible that heightened awareness of the symptoms of ovarian cancer will lead to better outcomes through early detection clinical trials—even though this approach has not yet been scientifically demonstrated.
To sum up a major change in practice
In clinical practice, during an office visit, a two-step algorithm for early detection of ovarian cancer is likely to be most effective:
STEP #1
In tandem with a physical examination, have the patient complete a questionnaire that focuses on such symptoms as abdominal pain, pelvic pain, abdominal bloating, increased abdominal size, early satiety, and difficulty eating.
STEP #2
If the patient reports that she experiences these symptoms more often than 12 days a month, order a serum CA-125 assay and pelvic US; pursue surgical evaluation in the presence of a positive test result or an abnormal finding on US.
Deployment of such an early detection approach to ovarian cancer represents a major change in gynecologic practice. And early detection will, we would hope, reduce the great suffering caused by ovarian cancer.
