Frequent Ovarian Cancer Screening Does Not Cause Sustained Psychological Harm
“Women participating in frequent ovarian screening who are recalled for an abnormal result may experience transient cancer-specific distress, which may prompt a reconsideration of risk management options,” reported lead author Kate E. Brain, PhD, Senior Lecturer at the Cochrane Institute of Primary Care and Public Health, Cardiff University School of Medicine, Cardiff, UK, and coauthors.
Women with family history of breast or ovarian cancer and who have BRCA1 or BRCA2 gene mutations face up to a 45% lifetime risk of developing ovarian cancer, the authors noted. The efficacy of annual ovarian cancer screening for genetically high-risk women has been discouraging, resulting in the creation of more frequent, 4-month CA125 tests combined with annual transvaginal ultrasound screening programs that can yield “a significant rate of false positive abnormalities,” the authors wrote.
The new study assessed whether more frequent screening is associated with increases in participants' depression or anxiety, and their likelihood of continuing to participate in screening programs. Psychometric questionnaires were completed by 1,384 particiants before and at several points in time after initial CA125-test and ultrasound screenings, starting 1 week after participants were informed of their initial test results.
Overall, 4-month screening programs had no significant sustained impacts on participants' general anxiety or depression levels, or overall reassurance, Dr. Brain and her colleagues reported.
However, women with abnormal initial screening results expressed moderately elevated cancer-related psychological distress at 1 week after receiving their test results (F=27.47, P≤0.001, η2=0.02), and withdrew from screening programs at that time at a significantly higher rate than did women with normal screening test results (OR=4.38; P≤0.001). However, among those who did not withdraw from screening 1 week after receiving abnormal results, abnormal test results did not correlate with subsequent levels of anxiety or depression.
The clinical efficacy of 4-month ovarian cancer screening programs has not yet been established, the authors cautioned.