USPSTF Releases Final Recommendation On Ovarian Cancer Screening
Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Discuss the USPSTF draft recommendations regarding ovarian cancer screening 2. Restate the risk factors for ovarian cancer
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2021, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
The USPSTF has posted its final recommendation regarding ovarian cancer screening on February 13, 2018. The Task Force is standing by previous guidance and considers the evidence sufficient to recommend against routine screening with transvaginal ultrasound and/or CA-125 for ovarian cancer.
This recommendation does NOT refer to women who are at increased risk for ovarian cancer, for example personal or family risk of the following:
Hereditary Breast Ovarian Syndrome (BRCA1 / BRCA2)
Family History of Ovarian Cancer
Transvaginal ultrasound and/or CA-125 measurements do not reduce deaths due to ovarian cancer
Excessive false positives in asymptomatic women lead to unnecessary surgical interventions
False positive rates range from 4.2% to 44.2%
Magnitude of harm rated from moderate to substantial depending on the risk of the unnecessary surgery
Percentage of women who went for unnecessary surgeries range from 0.2% to 3.2%
Insufficient evidence to determine if there are psychological harms as well
Other Professional Guidelines
Does not recommend screening for ovarian cancer in low-risk, asymptomatic women
Evaluation of high-risk women may include transvaginal ultrasound and CA-125 testing, in addition to physical examination
Does not recommend screening for ovarian cancer in average-risk women
Does not recommend screening for ovarian cancer in average-risk women
Recommends against screening for ovarian cancer in asymptomatic women (consistent with USPSTF)
There is at least moderate certainty that the harms of screening for ovarian cancer outweigh the benefits
There is adequate evidence that screening for ovarian cancer does not reduce ovarian cancer mortality
Based on 3 large good-quality studies, there does not appear to be any benefit in ovarian cancer mortality from annual screening in asymptomatic, non-high risk women
The USPSTF assessed studies that included CA-125
Whether CA-125 was used as a single cut-off measure or within the framework of an age-adujsted algorithm, there was no difference in ovarian cancer mortality
Based on the above, the Draft Recommendation is a ‘D’ Grade
The USPSTF recommends against screening for ovarian cancer in asymptomatic women
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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