Ovarian cancer screening ineffective, UAB study says | al.com

A commonly used test for ovarian cancer doesn't increase a woman's chance of survival and may in fact create other health problems, according to a study from UAB and elsewhere.

The study, which will appear in the Wednesday issue of the Journal of the American Medical Association and was released early online, looked at the use of transvaginal ultrasound and a blood test doctors use to find an early sign of ovarian cancer and other tumors called CA-125. The two diagnostic tests are often provided by doctors annually or given to women who request screening.

After looking at 13 years of results, the scientists concluded that women were no less likely to die if they'd gotten the tests.

"I think we get need to get the message out to the public and to physicians that this strategy is not effective and needs to be abandoned until we find one that is," said Edward Partridge, director of the Comprehensive Cancer Center at the University of Alabama at Birmingham, president of the American Cancer Society and one of the study's authors. According to the American Cancer Society, ovarian cancer is one of the top five cancer killers of women, who are usually diagnosed in the advanced stages and have a five-year survival rate of 30 percent.

Partridge and UAB's Mona Fouad joined the team of more than 30 scientists who analyzed an earlier trial from the National Cancer Institute. They looked at nearly 80,000 women aged 55 to 75 who had either annual ovarian cancer screenings or regular medical care. Only women with an average risk of getting the disease were included.

Over the course of the study, 212 cases were diagnosed in the screened group and 176 cases in the unscreened group. Of those, 118 members of the screened group died as a result of their cancer, and 100 members of the unscreened group died from ovarian cancer, a statistically similar death rate. In addition, both groups were diagnosed with similar stages of the cancer, so the tests weren't finding tumors early enough to make a difference.

Worse, the tests often produce false negatives that can let cancer go untreated or false positives that require women to undergo surgery to look for tumors. The side effects of the surgery can include infection, cardiovascular problems and bowel injury, the report says.

Partridge said cancer researchers had previously had doubts about the tests' effectiveness, partly because some ovarian cancer appears to be so aggressive that even annual screening can't catch it in time, and other cases seem to be so slow-growing they don't kill patients.

"This study just took away all doubts," he said.

Partridge said this study differs from a 2009 federal recommendation that women should no longer get routine mammograms for breast cancer before age 50. In that case, he and other cancer specialists argued that the benefits outweighed the reported risks and women should still get screenings starting at age 40.

He also said the new study shows there should be more research -- and more funding for studies -- into how to screen for ovarian cancer, whether that means finding more accurate markers than CA-125 or discovering better ways to look for the cancer in the body than sonograms.

Meanwhile a study under way in the United Kingdom that's expected to be published next year is looking at the changes in CA-125 over time -- that is, taking a baseline measure of the substance in the blood and then checking periodically to see if the number goes up slowly -- rather than just putting patients into an "OK" or "not OK" category based on a one-time reading.

Partridge said the team is recommending that women at high risk of ovarian cancer still get regular screening, with the warning that the tests may not be as effective as once thought.

See the study at: http://jama.ama-assn.org/

Join the conversation by clicking to comment or email Wolfson at hwolfson@bhamnews.com.

Source: http://blog.al.com/spotnews/2011/06/ovarian_cancer_screening_ineff.html

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