In a recent You Docs column in my local newspaper, a woman asked about new ways to detect ovarian cancer. She went on to state, “Each year I ask for an internal pelvic exam and a CA-125 test. My mom died from breast cancer and my sister from ovarian cancer.”
The first part of Dr. Oz’s answer was, “. . . these are your two best options: the CA-125 blood test, which you’re smart to be getting, and a transvaginal ultrasound exam.” The rest of the response does mention there are false positives, but is mostly glowing in its recommendation that she get the tests. What’s wrong with this advice?
The United States Preventive Services Task Force gives ovarian cancer screening its worst grade, D, which means they believe the potential harms outweigh the potential benefits. Even the gynecologists state, “There is no good test to screen for cancer of the ovary. For this reason, routine testing for ovarian cancer is not recommended.”
It is possible that this woman is from a family who has one of the BRCA genes, which greatly increases the risk of ovarian, breast, and related cancers. The gynecologists recommend screening in these especially high-risk women, though there are no clinical trials proving it does any good.
The most important factor missing from Dr. Oz’s column was humility. He fell back on the typical ologist mantra that more expensive technology delivers better care, and early detection of cancers solves most of our problems. There was no acknowledgement that medical science has no proven way of impacting ovarian cancer other than the treatments prescribed for disease once its found.
Are these screening tests just another exercise in false hope? No one knows. I don’t know, Dr. Oz doesn’t know, the gynecologists don’t know, all because no study answers the question. One thing we can be sure of is even if technology extends a few high-risk women’s lives, the cost of healthcare rises if the tests are ordered. I’ve never seen him mention that fact in his columns.