screening for ovarian cancer
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Pathology
- many high-grade serous ovarian cancers originate in the fallopian tube, thus serous tubal carcinoma in situ may be an entity[10]
- high-grade serous ovarian cancers are the most common subtype & the subtype with the highest mortality[11]
Indications
- USPSTF recommends against screening for ovarian cancer[1][7] except for women with a family history of ovarian cancer or breast cancer
- American College of Physicians recommends against screening for ovarian cancer[4]
- American College of Obstetricians and Gynecologists (ACOG) recommends against routine screening with CA-125 in serum or transvaginal ultrasound in BRCA mutation carriers or women with personal or family history[8]
- screening with ultrasound may benefit high-risk patients[12]
- no screening method has been shown to reduce mortality, even in high-risk women[13]
* No ovarian cancer screening tests have been cleared by the FDA[5]
Laboratory
- serum CA-125
- BRCA1/BRCA2 genotyping in women with a family history of breast cancer or ovarian cancer
- BRCA1 promoter methylation in leukocytes is positively associated with risk for high-grade serous ovarian cancer[9]
Diagnostic procedures
Management
- USPSTF recommends against screening for ovarian cancer[1][7], except for women with a family history of ovarian cancer or breast cancer
- no proven benefit for screening high-risk women (MKSAP19)[3]
- no mortality benefit to routine screening for ovarian cancer with transvaginal ultrasound &/or serum CA-125 testing[14]
- harms of screening are at least moderate[1]
- screening may detect ovarian cancers at earlier stage, but mortality is not improved[14]
- annual screening for ovarian cancer might lower ovarian cancer-related mortality[6]
- serum CA-125 with rising levels interpreted using an ovarian cancer algorithm & ultrasound as indicated
More general terms
Additional terms
References
- ↑ 1.0 1.1 1.2 1.3 Moyer VA et al Screening for Ovarian Cancer: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement Annals of Internal Medicine, 11 September 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22964825 <Internet> http://annals.org/article.aspx?articleid=1357339 (corresponding NGC guideline withdrawn Feb 2018)
- ↑ U.S. Preventive Services Task Force Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: U.S. Preventive Services Task Force Recommendation Statement. DRAFT. Summary of Recommendations and Evidence. available for comment from April 2 until April 29, 2013 http://www.uspreventiveservicestaskforce.org/draftrec.htm
Draft Evidence Report Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer. http://www.uspreventiveservicestaskforce.org/draftrep2.htm - ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2015
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 4.0 4.1 Wilt TJ, Harris RP, Qaseem A for the High Value Care Task Force of the American College of Physicians. Screening for Cancer: Advice for High-Value Care From the American College of Physicians. Ann Intern Med. 2015;162(10):718-725. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25984847 <Internet> http://annals.org/article.aspx?articleid=2294149
Harris RP, Wilt TJ, Qaseem A for the High Value Care Task Force of the American College of Physicians. A Value Framework for Cancer Screening: Advice for High-Value Care From the American College of Physicians. Ann Intern Med. 2015;162(10):712-717 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25984846 <Internet> http://annals.org/article.aspx?articleid=2293237 - ↑ 5.0 5.1 FDA Safety Alert. Sept 7, 2016 Ovarian Cancer Screening Tests: Safety Communication - FDA Recommends Against Use, http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm519540.htm
- ↑ 6.0 6.1 6.2 Jacobs IJ et al Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet. Dec 17, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26707054 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901224-6/abstract
Verheijen RH, Zweemer RP. Screening to improve ovarian cancer prognosis? Lancet. Dec 17, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26707055 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901236-2/abstract - ↑ 7.0 7.1 7.2 U.S. Preventive Services Task Force Draft Recommendation Statement. July 2017 Ovarian Cancer: Screening https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement174/ovarian-cancer-screening1
U.S. Preventive Services Task Force (USPSTF) Draft Evidence Review. July 2017 Draft Evidence Review for Ovarian Cancer: Screening https://www.uspreventiveservicestaskforce.org/Page/Document/draft-evidence-review166/ovarian-cancer-screening1
US Preventive Services Task Force Screening for Ovarian Cancer. US Preventive Services Task Force Recommendation Statement JAMA. 2018;319(6):588-594. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29450531 https://jamanetwork.com/journals/jama/fullarticle/2672638
Henderson JT, Webber EM, Sawaya GT. Screening for Ovarian Cancer. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018;319(6):595-606 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29450530 https://jamanetwork.com/journals/jama/fullarticle/2672637 - ↑ 8.0 8.1 American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 182 Summary: Hereditary Breast and Ovarian Cancer Syndrome. Obstetrics & Gynecology. 130(3):657-659, SEP 2017 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28832475 https://insights.ovid.com/crossref?an=00006250-201709000-00035
- ↑ 9.0 9.1 Lonning PE, Berge EO, Bjornslett M et al White Blood Cell BRCA1 Promoter Methylation Status and Ovarian Cancer Risk. Ann Intern Med. 2018 Jan 16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29335712
- ↑ 10.0 10.1 Narod SA Is There a Future for Ovarian Cancer Screening? JAMA Intern Med. Published online Feb 13, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29450456 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2672543
- ↑ 11.0 11.1 Lu KH Screening for Ovarian Cancer in Asymptomatic Women. JAMA. 2018;319(6):557-558 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29450509 https://jamanetwork.com/journals/jama/fullarticle/2672614
- ↑ 12.0 12.1 van Nagell JR Jr, Burgess BT, Miller RW et al. Survival of women with type I and II epithelial ovarian cancer detected by ultrasound screening. Obstet Gynecol 2018 Nov; 132:1091. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30303916 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30303916 https://insights.ovid.com/crossref?an=00006250-201811000-00002
Robertson SE, Peipert JF. Ultrasound screening for ovarian cancer: Are we there yet? Obstet Gynecol 2018 Nov; 132:1089. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30303915 https://insights.ovid.com/crossref?an=00006250-201811000-00001 - ↑ 13.0 13.1 Walker M, Jacobson M, Sobel M Management of ovarian cancer risk in women with BRCA1/2 pathogenic variants. CMAJ August 12, 2019 191 (32) E886-E893; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/31405835 <Internet> http://www.cmaj.ca/content/191/32/E886
- ↑ 14.0 14.1 14.2 Menon U et al. Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): A randomised controlled trial. Lancet 2021 May 12; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/33991479 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00731-5/fulltext