What "harms"?

Summary of Recommendation
The USPSTF recommends against routine screening for ovarian cancer. Rating: D Recommendation.

Rationale: The USPSTF found fair evidence that screening with serum CA-125 level or transvaginal ultrasound can detect ovarian cancer at an earlier stage than it can be detected in the absence of screening; however, the USPSTF found fair evidence that earlier detection would likely have a small effect, at best, on mortality from ovarian cancer. Because of the low prevalence of ovarian cancer and the invasive nature of diagnostic testing after a positive screening test, there is fair evidence that screening could likely lead to important harms. The USPSTF concluded that the potential harms outweigh the potential benefits.

I KEEP READING THAT EARLY DETECTION IMPROVES PROGNOSIS!!  DOES ANYONE UNDERSTAND WHY THIS USPSTF WOULD WRITE THIS?

[Shari4444]

I'm sorry, honey, but from experience, Doctor's don't routinely screene for ovarian cancer.
I'd been complaining for two years of symptoms and it was written off as pre-menopausal and stress. Not until I ended up in the hospital severly dehyraded and my elocolyyltes off the board, did they do a CAT Scan and find my tumor! they said it was amazing that I had walked into the hospital.
Get yourself an gyn/onc (ONC , being the important initials, here,) and see what he says. Good luck, and if you want to post on the "Care and Prayer" forum , just loof above this post....we're hpoing for record #'s.
                       Hugs,
                            Shari

[puppyluve]

It would be interesting to know what facts they follow. When they make comparisons do they use same type cancer against same type cancer? For example...My friend has stage 1 OVCA but because it is clear cell it makes a difference on her prognosis. However the diagnosis of a well differentiated cancer would seem to have a better prognosis if detected early.

What were the size of these groups? Are we talking about following 10, 100 or 1,000 people.

It seems to me that metastasis would make things so much more difficult to treat. You are no longer just dealing with the ovaries and uterus .... the area of treatment is broadened.

If this truly creates more harm then benefits then they need to put some serious money towards finding a better way of detecting and treating OVCA. When it came to men and their prostates they sure took the time and energy to find a test to detect. Shouldn't they do the same for women.

[vegas2cr]

I may not agree but here is their thinking... ca125 tests are not accurate in any pre menopausal women.... when they are elevated they then do perhaps a CT or ultrsound showing a cyst.. 96% of all cysts are benign.... but you don't know unless you operate... When I was diagnosed 4 of my friends demanded ca125 tests... 3 of them were elevated... none turned out to have ovarian cancer.. all 4 resolved within months on thier own... if you operated on every woman who had an elevated ca 125 and cysts you would proabably lose more on the operating table than you would save...  surgery is dangerous no matter how good your health is...

Ovarian cancer is rare believe me when I say I wish they would have found mine before it was stage IV.   I had  pap manual exam etc.. less that 11 months before I was diagnosed.. It just can't work...

I hope no  I pray that someone will come up with a test that says for sure.. and by the way as far as prostate cancer goes.. 5 years ago my husband had his PSA test and it was normal....1 year later it had risen and they did a biopsy... but with a man you can do a biopsy without major surgery... YES my husband had prostrate cancer and is now doing fine.... but its easy to get to the prostrate without undergoing major surgery... you can not get to the ovaries and or other parts as easy....

[Casey06]

If a doctor finds sufficient evidence (elevated CA-125, suspicious US or CT and symptoms) they would most likely perform a diagnostic laparoscopy  procedure. Serious complications of the procedure are rare. In around 2 in 1000 cases major surgery may be necessary to repair injuries to the various abdominal organs which can occur during insertion of the instruments through the abdominal wall. This risk is increased in patients with a history of the following: pelvic infections, abdominal surgery, severe endometriosis, obesity, or excessive thinness. Other risks include bruising around the incision sites and complications of anaesthesia. The risk of death during laparoscopy is around two per 100,000 which is less than the risk of death
during a pregnancy.

It is an invasive surgical procedure done for many gynecologic problems. It is definately an expensive way to get a definitive diagnosis, but when clearly indicated can save lives with early dx.

A relatively low cost screening test is needed:
http://www.sciencedaily.com/releases/2008/02/080212144500.htm

[vegas2cr]

Evidentally you have health insurance... for the millions of women who donot they can not afford CT scans etc.  I worked my entire life and became disabled with type 1 diabetes that I have had since I was 14 years old.... I am on social security disability and my medicare finally kicks in May of this year... 2 year wait...I am luckier than most I live in a foreign country that has allowed me to have almost $750,000.000 worth of treatment in the last year for less than $28,000.00.  

I am not stirring a pot but who is going to pay for all the surgery and if 1 life is lost that is too much... There needs to be a better way to detect this cancer..  

Complicatons from diabetes, heart disease and a host of other problems too..

Your heart is in the right place but it is not feasable until they come up with a method of screening that is light on the pocket book and easy on the body........

[puppyluve]

This illness makes people so frustrated....you just want something so that we don't have to go through this or watch our loved ones go through it. It just seems like they are not working as hard at finding a diagnostic test as they have in other cancers. I definitely know insurance is a big factor and being able to afford these tests. Even with insurance some people have such high deductibles. There is just so much that needs to be done it is so frustrating. You are a very good voice of reason.

[Meg2010]

Even with insurance, the primary care physicians are very concerned about explaing themselves to the insurance companies.  I have been working on my diagnosis and treatment going on two months.  I'm still waiting to get into a Gyn Dr.  

When I explained that my Mom had died of unknown cancer (according to symptoms, I realize now could have been ovarian) the Dr. said I just had "anxiety" about my Moms cancer ...and I thought I was just using my head.  It's a real "concern" not an "anxiety" issue.  

So, it could be just a benign cyst, but what if it's not and they didn't think everything through?  

[Casey06]

That was my point...read my last line..."A relatively low cost screening test is needed:
http://www.sciencedaily.com/releases/2008/02/080212144500.htm "

Yeah $750,000 in one year of treatment vs. early detection....hmmm??

[Sandymac]

Evidently "they" are working on a urine test that shows promise. Can't remember where I read about it .
     And ,even though it may not be recommended etc., there is a Gyn . in Tampa Fl that orders TVUS routinely on every one of her patients' annual exams.  She was featured on Fox News 13 . Her feeling is that it is as important as Mammograms. Further, even Mammograms do not have 100% accuracy , so that argument doesn't hold water as far as she's concerned.. Wish they all had that mentality..

[Sandymac]

P.S. I wish every Dr. out there could have a copy of Kimmie's (Lilbubba's) notes from this forum and journal. They may then have to "sit up and take notice" .. It is criminal the way she was "dismissed"

[vegas2cr]

Low cost would be wonderful.......... I have 2 daughters one is 39 and one is 42.  When they both went to the doctor and told him I had ovarian cancer he immedicately ordered a ca125 and then ordered a trans vaginal ultrasound.. Now one live in Nevada and one lives in Calif.. 2 different states.. both had tosign a form that if the insurance didn't pay they would... Neither insurance company paid and my daughters Doctor in Vegas intervened with the insurance company and they finally paid.. my other daughters doctor also sent a letter explaining why it was iimportant for those tests and they just got the 2nd claim denial...
Until Insurance companies become interested in prevention there will be a problem  

and Casey,I read your point and there was no reason for your sarcasm... I understand what you were saying.. I agree that prevention is better than full cost... too bad the insurers don't.  Now maybe you are frustrated but you came across RUDE.