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Biological diversity of ovarian cancer lessens value of screening
Date:12/13/2010

ltrasound to screen a general population of post-menopausal women for ovarian cancer.

In conceptualizing ovarian cancer as a single disease, the model predicted that screening women over the age of 50 in the United States could potentially lower cancer deaths by about 15 percent. But incorporating the two subtype concept, the model predicted deaths would fall by only 11 percent.

Havrilesky says it just makes sense: Screening is more likely to pick up a greater number of slow-growing, as opposed to fast-growing tumors, because indolent cancers remain in a more treatable early stage almost twice as long as their more virulent counterparts. "But catching and successfully treating the slower-growing cancers isn't going to do as much to reduce deaths from ovarian cancer as much as catching the more lethal tumors would do."

In an accompanying editorial, Patricia Hartge, MA, ScD, a senior investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, notes the modest benefit of screening for a general population, but says that screening for women at higher risk of ovarian cancer those who carry mutations known to be related to the disease or who have a family history of it presents a more hopeful picture.

But Havrilesky is not so sure. She says screening in even the highest risk population has not yet been proven successful and says other options are under study that may hold merit.

'We know that women who take oral contraceptives have a reduced risk of ovarian cancer, and the Duke Evidence-Based Practice Center is currently doing a systematic review and model to determine if this might be a reasonable approach for some women."


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Contact: Michelle Gailiun
michelle.gailiun@duke.edu
919-660-1306
Duke University Medical Center
Source:Eurekalert

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