March 8, 2018—Sometimes the risks of screening outweigh the benefits. That's true for ovarian cancer screening for a majority of women, according to the U.S. Preventive Services Task Force (USPSTF). So if you're not at high risk for ovarian cancer and have had no symptoms of it, you can skip the screening.
The trouble with subtle symptoms
Ovarian cancer usually occurs in women 45 and older and causes about 14,000 deaths per year. Symptoms can be hard to pinpoint, since they include abdominal pain, pressure or feeling bloated. And these kind of symptoms usually have other less serious causes.
Also, in many cases these symptoms don't show up until the later stages of the cancer. Doctors screen for the cancer using an ultrasound, pelvic exams and certain blood tests.
The pros and cons of screening
The USPSTF weighed the benefits against the harms of screening for ovarian cancer. They focused on women without symptoms and who were not at high risk due to a hereditary cancer syndromes.
Here's what they found: False-positive screenings could result in unnecessary surgeries. And screening for ovarian cancer does not reduce the number of people who die from it. These findings align with recommendations from the American Cancer Society and the National Cancer Institute as well—benefits of screening don't outweigh the risks.
It's important to know that this recommendation does not apply to women who have certain family cancer syndromes, such as those with inherited mutations in the BRCA1 or BRCA2 genes. These put women at higher risk for ovarian cancer.
Women who have a family history of ovarian cancer are included in the USPSTF's general recommendation against screening. However, women with a family history of ovarian or breast cancer may be at risk for those hereditary cancer syndromes and should speak with their doctor. The USPSTF recommends that these women consider genetic counseling and, when appropriate, genetic testing to be sure.
The USPSTF statement is published in JAMA.
So what should you do?
The symptoms of ovarian cancer are hard to define. In addition to abdominal pain and pressure, they may include constipation, urinary symptoms, back pain and fatigue.
To protect yourself, be aware of the risk factors. First off, ovarian cancer is rare in women under the age of 40. It most often develops after menopause.
Other risk factors include:
- Being obese.
- Having your first full-term pregnancy after age 35 or never carrying a pregnancy to term.
- Using fertility drugs, androgens (male hormones) or hormone therapy.
- Having a family history of breast or certain other cancers or a personal history of breast cancer (especially where a family cancer syndrome is at work).
And a few factors that may lower your risk:
- Using birth control pills. The longer you use them, the lower your risk.
- Having your tubes tied or a hysterectomy.
- Following a low-fat diet.
Your best bet is always to discuss your risks and options with your doctor, who can help you make the best decisions based on your own health history.