Clinical Edge

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Early Detection of Epithelial Ovarian Cancer

Obstet Gynecol; 2017 Sep; ACOG Comm on Ethics

There currently is no strategy for early detection of ovarian cancer that reduces ovarian cancer mortality; therefore, women and their obstetrician-gynecologists should maintain an appropriate level of suspicion when potentially relevant signs and symptoms of ovarian cancer are present. This according to a new committee opinion from the American College of Obstetricians and Gynecologists (ACOG) and the Society of Gynecologic Oncology on the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Among the recommendations and conclusions:

  • Currently, there is no strategy for early detection of ovarian cancer that reduces ovarian cancer mortality.
  • The use of transvaginal ultrasonography and tumor markers (such as CA 125), alone or in combination, for the early detection of ovarian cancer in average-risk women have not been proved to reduce mortality, and harms exist from invasive diagnostic testing resulting from false-positive test results.
  • Epithelial ovarian cancer is most commonly detected in an advanced stage when the cure rate is only 18%.
  • Early stage (localized) ovarian cancer is associated with improved survival.
  • Taking a detailed personal and family history for breast, gynecologic, and colon cancer facilitates categorizing women based on their risk (average risk or high risk) of developing epithelial ovarian cancer.
  • The patient and her obstetrician–gynecologist should maintain an appropriate level of suspicion when potentially relevant signs and symptoms of ovarian cancer are present.

Citation:

The role of the obstetrician–gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Committee Opinion No. 716. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;130:e146–9.