Screening for Ovarian Cancer: No New Answers
Ovarian cancer has been called the "disease that whispers". While not as prevalent as other female cancers (think breast, lung), it remains one of the most difficult cancers to detect, and therefore, treat. A recent trial published in the June 8th edition of the Journal of the American Medical Association (JAMA) shows that current screening techniques had no effects on reducing mortality from ovarian cancer.
According to the National Cancer Institute, 1 in 72 women will develop ovarian cancer in their lifetime. However, diagnosis of this type of cancer remains difficult. Symptoms are often generalized, common and often mistaken for other (more benign) conditions. Women may complain of such symptoms as abdominal bloating, stomach pain, changes in bowel function and back pain. By the time most cases of ovarian cancer are finally identified, the tumors have often migrated beyond the reaches of the ovary. Because of the metastatic nature of these tumors, the five-year survival of most cases is quite low (27.2%).
The Prostate, Lung, Colorectal and Ovarian (PLCO) trial, conducted by the National Institutes of Health, sought to determine whether early screening could reduce deaths caused by ovarian cancer. The study group consisted of approximately 70000 women, half of whom received yearly screening for ovarian cancer (ultrasounds and blood tests) and half who did not. Unfortunately, these screening techniques resulted in many false positive results (women testing positive for cancer, when they had none) and subsequent unnecessary surgeries. In addition, the current screening techniques were found to be inadequate in detecting ovarian cancer cases in the early stages (stages 1-2) when five-year survival rates are above 90%.
The focus of ovarian cancer research remains understanding the early disease course, the behavior of young cancer cells, and how best to detect the changes in ovarian tissue in the earliest stages of the disease. Until the research develops further in this area, ovarian cancer will continue to be the elusive, and frightening "disease that whispers".
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