There is more good news in the screening of people at high risk for lethal diseases. Recall the post on this website in December, 2016 looking at screening for pancreatic cancer in a high risk group. Click here for the link. Now from the United Kingdom comes a very interesting study of screening for ovarian cancer in a high-risk group. Click here for that link. If you wish the entire article email Dr. Stark on the form to the right of this posting. According to the authors, based on an algorithm they created, women with a lifetime risk of 10% or greater of developing ovarian cancer were recruited and enrolled in their study. They identified over 4000 women who underwent over 13,000 screenings over a five-year period. The screenings included the CA-125 blood test and trans-vaginal ultrasound. 19 women were diagnosed during this period with ovarian cancer. 10 of the 19 were stage I. All of these women would be expected to survive. Of additional interest is that the authors counseled all of these women to undergo prophylactic salpingo-oophorectomy but only about 12% agreed to this approach, and so were removed from subsequent analysis.
Dr. Stark weighs in: Traditionally screening for uncommon highly lethal cancers was discouraged because of the unfavorable cost to benefit ratio. Now we have two examples where selecting for appropriateness of subsequent intensive screening based on risk can result in a higher yield of positive results and a dramatic reduction in mortality for those at highest risk of getting the disease. As more widespread genetic testing is done now that the cost of such testing is plummeting, we will be in a better position to know who should be screened; and data in support of such screening will be forthcoming.