Ovarian cancer screening reduces death rate only modestly
Ovarian cancer is one of the most feared diseases because the tumor often produces no symptoms and the disease is often detected at an advanced stage. Despite vigorous research, there are no good screening tests that can be recommended for all women on a regular basis, such as there is with breast cancer and mammography. And that is unlikely to change anytime soon.
In a study reported Monday, researchers used a mathematical model to predict that death rates would fall by only about 11% from their current levels if women were to undergo regular ovarian-cancer screening with the best available technology. That technology is the CA 125 blood test followed by ultrasound imaging of the ovaries if the CA 125 test is abnormal.
The reason why screening with the current methods is underwhelming may be because there are different types of ovarian cancers. The authors of the study, from Duke University Medical Center, estimated that some ovarian cancers are slow-growing, spending about 24 months at Stage I and 12 months at Stage 2. A more aggressive phenotype is assumed to spend about eight months at Stage I and only five months at Stage 2 before advancing.
“If we assume ovarian cancers grow and spread at different rates, the best screening strategy available will only reduce the number of women dying from the cancer by 11%,” the lead author of the paper, Dr. Laura Havrilesky, said in a news release. “This is partially because the slower growing cancers are more likely to be caught by a screening test.”
It may be time to invest more effort in prevention and treatment of ovarian cancer since screening has shown such little value so far, the authors noted. However, in a commentary accompanying the study, experts pointed out that while routine screening is not recommended for everyone, women with a significant family history of the disease or who carry genes that increase the risk should talk to their doctors about the value of regular screening.
The study was published in the journal Cancer.
Related: Symptoms absent in 80% of ovarian cancer patients.
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