Putting Prevention into Practice

An Evidence-Based Approach

Screening for Ovarian Cancer

 

Am Fam Physician. 2018 Jun 15;97(12):813-814.

Related U.S. Preventive Services Task Force Recommendation Statement: Screening for Ovarian Cancer: Recommendation Statement.

Author disclosure: No relevant financial affiliations.

Case Study

A 61-year-old woman presents to your office for a well-woman examination. She had a normal Papanicolaou (Pap) test last year and has no medical problems. She quit smoking 10 years ago, reports a family history significant only for cardiovascular disease, and is sexually active with her husband.

Case Study Questions

1. According to the U.S. Preventive Services Task Force (USPSTF), should this woman be screened for ovarian cancer?

  • A. No; the USPSTF recommends screening for ovarian cancer only in asymptomatic women 65 to 79 years of age.

  • B. Yes; the USPSTF recommends screening for ovarian cancer with transvaginal ultrasonography in asymptomatic women.

  • C. No; the USPSTF recommends against screening for ovarian cancer in asymptomatic women.

  • D. Yes; the USPSTF recommends screening for ovarian cancer with serum cancer antigen 125 (CA-125) testing.

  • E. Maybe; the USPSTF concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for ovarian cancer.

2. To which one of the following women does the USPSTF recommendation statement on screening for ovarian cancer apply?

  • A. A 45-year-old asymptomatic, nulliparous woman recently diagnosed with hereditary breast and ovarian cancer syndrome.

  • B. A 68-year-old woman with a two-year history of lower abdominal pain, bloating, and fatigue.

  • C. A 40-year-old asymptomatic woman with a known BRCA1 deleterious gene mutation.

  • D. A 65-year-old woman with no symptoms.

  • E. A 60-year-old woman with a recently detected palpable mass in her left lower quadrant.

3. Screening for ovarian cancer results in which of the following harms?

  • A. Unnecessary surgery.

  • B. Reduced compliance with other well-woman screening recommendations.

  • C. Anxiety.

  • D. High false-positive rate.

Answers

1. The correct answer is C. The USPSTF recommends against screening for ovarian cancer (D recommendation) in asymptomatic women regardless of age or screening methodology. The USPSTF found that the harms of screening outweigh the benefits. Studies

Author disclosure: No relevant financial affiliations.


The views expressed in this work are those of the authors and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, the U.S. Air Force, the Department of Defense, or the U.S. government.

References

1. US Preventive Services Task Force. Screening for ovarian cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(6):588–594.

2. Henderson JT, Webber EM, Sawaya GF. Screening for ovarian cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319(6):595–606.

This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and the supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/ovarian-cancer-screening1.

This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.

A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.

 

 

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