Published: September 11, 2012
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New evidence that women are more likely to be harmed than helped by screening tests for ovarian cancer is disturbing. The tests do nothing to prevent healthy women from dying from the usually fatal disease. Yet they often lead doctors to perform needless surgeries that cause serious complications in many patients.
The judgment from the United States Preventive Services Task Force, issued on Monday, updates its longstanding verdict that healthy women with an average risk of ovarian cancer should not be screened for the disease. The task force, 16 federally appointed experts, makes recommendations on which screening tests work and which don't. The American Cancer Society and the American Congress of Obstetricians and Gynecologists have also discouraged the use of screening tests for ovarian cancer in most women.
Such advice does not apply to women who have genetic mutations or a family history that puts them at high risk or to women who have suspicious symptoms, like persistent bloating and pelvic or abdominal pain, symptoms that are not unique to ovarian cancer.
The task force relied heavily on a large study published last year of 78,000 women ages 55 to 74, half of whom were screened with ultrasounds and blood tests for a biological marker of ovarian cancer, and half of whom were not. After following them for 11 to 13 years, the death rate from ovarian cancer was the same in both groups. But nearly 10 percent of those screened, more than 3,200 women, had false-positive results and more than 1,000 of them had surgery, usually to remove one or both ovaries. Many of them had serious complications, such as surgical injuries to other organs, infections and blood clots.
As Denise Grady pointed out in The Times on Tuesday, the problem with the tests is that the biological marker being measured (CA-125) can be elevated by conditions other than cancer and the ultrasounds can reveal benign cysts that cannot be distinguished from cancer without surgery to remove the ovary.
Despite the expert advice against routine screening, a survey of 1,000 doctors published in February found that a third of them believed that screening was effective and many offered it to patients. Many patients request screening, believing that it can find the disease early enough to save lives. It is long past time for doctors and their patients to recognize that this assumption is wrong.
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The Anti-Ovarian Cancer Diet
By William W. Li, MD President, The Angiogenesis Foundation
Experts believe that one-third of all cancers can be prevented by what you eat. Here are four foods known to be protective against ovarian cancer. Endive Endive is a salad vegetable. Studies of more than 62,000 women in the Netherlands have found those who ate endive had a 75% reduction in the risk of ovarian cancer. Endive contains a naturally occurring cancer fighter called kaempferol (also found in spinach, kale and broccoli).
Researchers have discovered that when ovarian cancer cells are exposed to kaempferol, they die. Protective Prescription: Research shows you should eat a half-cup of endives, twice per week. Onion Eating: onions has been shown to reduce the risk of many types of cancer, including ovarian cancer. Red onions are about 60% more potent than yellow or white onions, in terms of the amounts of cancer fighters. Protective Prescription: To protect against ovarian cancer, you should eat a half-cup of onions - cooked or raw - every day. Fish a series of studies from Northern Italy showed that eating fish reduced the risk of ovarian cancer by 30%. Omega-3 fatty acids in fish that are good for your heart and protect against stroke also protect against cancer. Protective Prescription: Research suggests eating 6-oz servings of fish 2-3 times per week. Tomato: Tomatoes protect against ovarian cancer. A study of 13,000 women in California showed that eating a half-cup of tomatoes five or more times a week reduced the risk of ovarian cancer by more than 60%. What's in tomato? Lycopene - and it's anti-angiogenic, too.