Two weeks ago, during Gynecologic Cancer Awareness Month, the United States Preventative Services Task Force announced and reinforced the previous findings that yearly screening with a CA-125 (a blood test that looks for a tumor protein that may be secreted from ovarian cancers) and pelvic ultrasound is ineffective in detecting this devastating disease at its earliest stages.
This statement merely reinforces the finding of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO Trial), in which a large number of women in the United States were screened for ovarian cancer with a yearly CA-125 and ultrasound. This study found that women, and the medical professionals who care for them, should not be reassured by a normal CA-125 and ultrasound. Furthermore, it was stated and reinforced that screening women for ovarian cancer with this technique can lead to more harm through surgical complications. A few points, however, need to be made.
• First, this is not new news. A number of studies and experts have, throughout the years, analyzed the previously published screening data and made similar statements. We now know that the yearly screening test employing an absolute “positive” or “negative” CA-125 value and ultrasound is not effective in detecting the disease at its earliest stage, when it is most curable. This had led investigators to study the effectiveness of every-six-months testing with a CA-125 and ultrasound, rate of rise of CA-125, and incorporation of personal risk factors for the disease into screening. The so called “Risk of Ovarian Cancer Algorithm” has been, and continues to be, investigated by researchers in the United States and United Kingdom.
• Second, this statement applies only to the woman in the general population who has no identifiable significant risk factors for the disease. This statement does not apply to women who have a family history of breast and ovarian cancer that suggests a hereditary component. For these women, who may have an up to 44 percent chance of developing the disease, screening with an every-six-months ultrasound and Ca-125 is generally recommended until (if/when) the ovaries are removed. (See “Preventing ‘Ovarian’ Cancer: Remove the Fallopian Tubes?”)
What does this statement mean for women in terms of prevention and early detection of ovarian cancer? It signifies and strengthens the fact that more research needs to be conducted in order to develop effective strategies for disease prevention, risk reduction, and screening. Women, and their physicians, also need to be aware of factors that may place a woman at elevated risk to develop the disease, so that effective risk reduction strategies can be employed. Women and their physicians need to be aware of the early warning signs and symptoms of ovarian cancer, such as urinary frequency, bloating, pelvic pain, fatigue, abnormal bleeding. (See “Ovarian Cancer: Yes, There Are Early Warning Signs and Symptoms.”)
A great resource for information on early detection of ovarian cancer and warning signs and symptoms of ovarian cancer is Project Hope for Ovarian Cancer.