In September, the U.S. Preventive Services Task Force, a panel of medical experts, concluded that tests to screen for ovarian cancer do more harm than good. As a result, insurers will not be required by federal law to pay for such tests.
And the announcement was met with near silence.
Why was this recommendation greeted with such malaise when the same panel’s earlier and similar conclusions about prostate cancer screening and breast cancer screening (in women less than 40 years old) created a tsunami of criticism? Here are a couple of reasons, one morbid and the other psychological.
First, ovarian cancer is often a fatal disease, often rapidly so. That means there is not a crowd of ovarian cancer survivors around to lobby for more aggressive screening. By contrast, prostate and breast cancers are often quite slow-growing, so slow in fact that many experts assert that many of these cancers are best left to their own devices. This slowness, in fact, is what has made it so difficult to assess the benefits of screening for these cancers. When people live for many years, even decades, following a cancer diagnosis, it is hard to conduct trials large enough to find any kind of survival benefit to screening or early treatment. In the case of ovarian cancer, however, a truly effective screening test —if it saved lives—would be relatively easy to establish. So it’s clear that our lack of a good screening test is not simply the result of underpowered clinical trials. We just don’t have anything that works. And we also don’t have a whole lot of ovarian cancer survivors, convinced that the screening test saved their lives, who can lobby for more aggressive screening.