Angelina Jolie’s disclosure about having her breasts and ovaries removed to prevent cancer has stimulated a lot of discussion on ovarian cancer. Most women know the importance of routine screening for breast cancer with mammograms/thermography as well as self-examinations but what about ovarian cancer? What kind of screening is available for ovarian cancer and when should it be done? What are the signs and symptoms of ovarian cancer? How prevalent is it?
The American Cancer Society (ACS) projects that “approximately 22,000 women will be diagnosed with ovarian cancer and an estimated 14,000 will die from the disease this year. Ovarian cancer is the ninth most common cancer among women and fifth in cancer deaths.”
Despite these numbers the US Preventive Services Task Force (USPSTF) does not recommend universal screening for ovarian cancer on asymptomatic women with low risk for the disease. By now you’re wondering, “WHY NOT?!” Let me try to explain: there is no evidence of a reduction in deaths associated with ovarian cancer screenings, in fact there may be increased harm related to evaluation and treatment based on false-positive findings from the screening methods.
The two screening methods for ovarian cancer include a transvaginal ultrasound (TVUS) and the CA-125 blood test. TVUS is used to detect masses but cannot tell if the mass is benign or malignant. This may lead to unnecessary surgeries. CA-125 is a protein in the blood that may increase with the presence of ovarian cancer. However, the test is nonspecific and may not be elevated in the presence of ovarian cancer or it may be elevated in the presence of other common conditions. Therefore screening for ovarian cancer using TVUS and CA-125 in asymptomatic and low risk women may lead to unnecessary and invasive procedures that can cause more harm than good.
However, if you have the following risk factors and are experiencing the symptoms below you should discuss screening for ovarian cancer with your gynecologist.
Risk factors for ovarian cancer:
- BRCA1 or BRCA2 gene mutation
- Lynch syndrome (hereditary nonpolyposis colon cancer)
- Family history of ovarian cancer
Symptoms suggestive of ovarian cancer:
- Pelvic or abdominal pain
- Difficulty eating or feeling full soon after eating
- Urinary symptoms: urgency or frequency
You can read more about ovarian cancer here.