Contrary to Evidence, Some Doctors Recommend Ovarian Cancer Screening ► NCI Cancer Bulletin for February 21, 2012 - National Cancer Institute

Contrary to Evidence, Some Doctors Recommend Ovarian Cancer Screening

One in three doctors believes that screening for ovarian cancer is effective, according to a recently published survey of practicing physicians, even though substantial evidence to the contrary exists. The findings, published February 7 in the Annals of Internal Medicine, suggest that some women may be exposed to the risks of screening, such as unnecessary surgeries and procedures that result from false-positive tests, and may incur unnecessary costs.
No professional organization supports ovarian cancer screening, regardless of a woman’s risk. Moreover, the U.S. Preventive Services Task Force has recommended against routine screening for ovarian cancer since 2004, and more evidence against screening for ovarian cancer emerged last year. Transvaginal ultrasound, the CA-125 blood test, or both are used to screen for ovarian cancer.
In the new study, family physicians, general internists, and obstetrician-gynecologists answered a questionnaire that included a vignette about a woman’s annual examination. Overall, 65 percent reported that they “sometimes” or “almost always” offered or ordered ovarian cancer screening tests for medium-risk women, and 29 percent did so for low-risk women. Moreover, 24 percent routinely (almost always) ordered or offered tests for medium-risk women, and 6 percent did so even for low-risk women. Physicians were more likely to report that they ordered screening tests when the patient in the vignette requested it.
“These findings are cause for concern, given that the risks of ovarian cancer screening outweigh the benefits,” said lead investigator Dr. Laura-Mae Baldwin of the University of Washington. “Sometimes physicians are enthusiastic about cancer screening before the [scientific] evidence shows that the benefits outweigh the risks.”
As with all surveys, this study included potential sources of bias, noted Dr. Barnett Kramer, director of NCI’s Division of Cancer Prevention and editor-in-chief of the NCI Physician Data Query (PDQ) Screening and Prevention Editorial Board. Nonetheless, he echoed concerns about how often doctors do not follow current screening recommendations and the “prevalence of faith in the effectiveness of screening.”
“A substantial proportion of the health professionals who responded to the survey may have been unaware that the only randomized controlled trial of ovarian cancer screening, published last year, showed no reduction in risk of dying from ovarian cancer in the general population,” Dr. Kramer wrote in an e-mail. “But the study did show harms associated with screening.”
The survey, he continued, shows the need for “enhanced educational efforts for the professional community regarding what is known about the balance of benefits and harms associated with ovarian cancer screening.”

NCI Cancer Bulletin for February 21, 2012 - National Cancer Institute: - Enviado mediante la barra Google