Ovarian cancer screening persists despite advice against it
Australian Doctor Group
Staff AusDoc Article
Ovarian cancer screening persists despite advice against it: survey
Many women, including those at only average risk, are undergoing screening for ovarian cancer despite Australian guidelines advising against it, a study suggests.
Researchers, led by the Peter MacCallum Cancer Centre in Melbourne, surveyed more than 800 patients and 250 doctors to investigate attitudes to ovarian cancer screening.
Randomised controlled trials have failed to demonstrate that annual screening via transvaginal ultrasound and/or CA125 improves survival rates among women, the researchers said.
And some studies show false positive results from screening leads to harm, including unnecessary surgery and cancer-specific distress.
Despite this, among a cohort of 832 women from families with multiple cases of breast cancer, the research team found 15% had undergone ovarian cancer screening in the past two years.
Only 4% of the entire cohort (ages 25-70) were BRCA1/2 mutation carriers. The women’s cancer risk ranged from average to high based on family history and germline mutation status.
Almost 80% said they would continue with screening even if their doctor told them it was ineffective, because they wanted to ‘stay healthy for family’ and for ‘peace of mind’.
Meanwhile, most of the 192 GPs surveyed agreed there was no reliable way to detect ovarian cancer early and screening could lead to unnecessary investigation.
Nevertheless, more than 40% said they still thought screening could be useful and a similar proportion had actually ordered ultrasound or CA125 testing in the past two years.
Their reasons included patient request (21%), a chance of early detection (16%), patient peace of mind (14%) and no other available screening options (11%).
Better education and possibly restricted access to screening should be considered, the authors said.