Controversy Surrounding Cancer Screening?

Screening for ovarian cancer is not only a poor way to do early diagnosis but may be worse for the women being screened. This is the worrying final analysis of cancer experts generally and the US Preventive Services Task Force in particular. They report in the Annals of Internal Medicine:

“There is no existing method of screening for ovarian cancer that is effective in reducing deaths. In fact, a high percentage of women who undergo screening experience false-positive test results and consequently may be subjected to unnecessary harms, such as major surgery.”

Cancer screening of the ovaries is about two things, namely scans and blood tests that seek to identify cell markers known to be predictors of the condition. So now it is being ruled out of the diagnostic armoury for women who show no signs of cancer and for women who have the genetic aberrations known as BRCA1 and 2. These aberrations increase the probabilities of the woman developing ovarian cancer but are not to be monitored by routine screening. This judgment is reinforced in the opinion of both the American Cancer Society and the American Congress of Obstetricians and Gynaecologists.

Ovarian Cancer Screening?

Ovarian cancer is one of the least known types and the fifth biggest killer among all cancers. Only around 22 hundred new cases occur in the US each year, but there are around 15 hundred deaths every year because of it. This latest pronouncement from the Task Force reaffirms a judgment from ‘04. It is based on further evidence since the first assessment. A review of cases showed that trans vaginal ultrasound scanning and blood tests known as CA-125 do nothing to improve the mortality rate associated with this cancer. According to the Task Force, “This is very high-quality evidence, it very strongly supports not screening and there is a risk of serious harm associated with screening.”

One particular piece of evidence is compelling; Over 78 thousand cases of the diagnosed cancer revealed the women who had been screened had the same mortality rate as those who had not.

Should You Get Screened for Prostate Cancer?

The Task Force also set their collective faces against, ‘prostate specific antigen’, a well-used screening procedure for prostate cancer. The risks of a false positive result and the subsequent excess, unnecessary treatment is too great and led the Task Force to call a halt to its use. Mammograms to screen for breast cancer are also not now seen as the first or best line of defence. The task force said there are more risks than benefits in them for 40 something women and older women at only average risk of breast cancer should be investigated biannually.

But it is the evidence against the effectiveness of ovarian cancer screen that is most obvious. By the stage at which a tumor is detectable by ultrasound scanning it is already dangerously advanced. Add to this the alarmingly high number of false positives and the screening program flies in the face of the Hippocratic oath’s prime directive, ‘to do no harm’. An invasive biopsy carries its own difficulties.