Prevention magazine editor promotes ovarian cancer screening despite lack of evidence

Diane Salvatore, Editor-in-Chief, Prevention Magazine, writes on the Huffington Post about “The Cancer You’re Probably Not Being Screened For.

Specifically, she advocates for transvaginal ultrasound screening for ovarian cancer.

Here’s what the American Cancer Society states about that approach:

“these tests are not recommended for women at average risk”

Here’s what the National Cancer Institute says:

“There is inadequate evidence to determine whether routine screening for ovarian cancer with serum markers such as CA 125 levels, transvaginal ultrasound, or pelvic examinations would result in a decrease in mortality from ovarian cancer.”

More from the Memorial Sloan-Kettering Cancer Center:

“There is no clear evidence to suggest that ovarian cancer screening with currently available methods will result in a decrease in the number of deaths from ovarian cancer.”

The Los Angeles Times reports:

Ovarian cancer screening does more harm than good, study shows

An 18-year study by the National Cancer Institute finds that ultrasounds and blood tests aimed at early detection don’t save lives, but expose women to avoidable complications.

“Every professional group says ‘no screening for average-risk women,'” said Dr. Beth Karlan, who directs the Women’s Cancer Research Institute at Cedars-Sinai’s Samuel Oschin Comprehensive Cancer Institute in Los Angeles. “We need to be sober in listening to the result.”

In her column, Salvatore encourages readers to join the Ovarian Cancer National Alliance – among other groups – “to educate the public about this senseless killer.” But a comment left on the Huffington Post site in response to Salvatore’s column from a woman who says she represents the Ovarian Cancer National Alliance states:

“there remains no reliable early detection or screening test. Unfortunat­ely, the medical data does not show that receiving a transvagin­al ultrasound and CA-125 blood test at an annual exam will save women’s lives.

In fact, a multi-year study of almost 80,000 women showed that annual CA-125 tests for six years and annual ultrasound­s for four years helped diagnose more women but did not save lives. False positive tests did not necessaril­y cause psychologi­cal harm, as this article implies, but rather physical harm through unnecessar­y surgery and associated complicati­ons from those surgeries. These are not minor risks; some women died as a result of unnecessar­y surgeries.

The current tools we have are just not appropriat­e for annual screening. This is unfortunate, as women diagnosed in early stages of ovarian cancer live longer than those diagnosed in later stages. However, we cannot advocate for policies or practices that are not firmly rooted in the science.”

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Gregory D. Pawelski

September 15, 2011 at 6:30 pm

While screening for ovarian cancer in the general population, regardless of age, is not recommended with presently available tools, by the U.S. Preventive Services Task Force, the American Cancer Society, the American College of Obstetricians and Gynecologists, and the National Comprehensive Cancer Network, certain high-risk segments of the population may benefit from screening. According to the American College of Obstetricians and Gynecologists, screening is recommended for some very high-risk women, ie, those with a specific inheritable ovarian cancer syndrome or with two first-degree relatives with epithelial ovarian cancer. But Ms. Salvatore addressed the broad population of women at average risk. As stated above, there isn’t evidence to support her recommendation to readers of the Huffington Post – most of whom are at average risk.