Ovarian cancer is rare, but it often spreads without causing symptoms and is only detected once it's too late. Genetic testing can determine if a woman is likely to develop the disease, but a troubling study found that many doctors are suggesting the testing for women who don't really need it, while others fail to identify women who are at high risk.
According to Reuters, guidelines encourage doctors to recommend genetic testing for patients who have several cases of breast or ovarian cancer in their family, but not for the average woman. For a survey published in the journal Cancer, 1,900 American physicians were given fictional descriptions of patients with an average, medium, or high risk, and asked what they'd recommend. 30% said they would suggest screening for a woman who isn't particularly likely to develop the cancer, while 60% wouldn't encourage a woman at high risk to get tested.
While it may seem like the more screenings the better, Jacqueline Miller of the CDC, who worked on the study, says this would unnecessarily alarm women and lead to some false positives. As she puts it:
"You would be over-testing a lot of women, spending a lot of resources and a lot of money ... For a lot of women, just going through the test creates a lot of anxiety."
At most, one in 300 women have mutations on the BRCA 1 and 2 genes, which indicate they're more likely to develop breast and ovarian cancer. Aside from the emotional impact of performing the test, the procedure is expensive and could put a strain on the healthcare system. Though patients usually wind up paying $100, the company Myriad Genetics charges $3,340 for the tests.
On the other hand, the test can be crucial for high risk women. Of those who test positive for BRCA 1 mutations, 57% get breast cancer by age 70 and 40% get ovarian cancer. After testing positive, many women start preventative treatments including removing their breasts and ovaries. While there may be some drawbacks to testing women with an average risk, the researchers say it's most important to teach doctors to better identify high-risk patients. Michael LeFevre of the U.S. Preventive Services Talk Force said, "Physicians can't be expected to carry all of these nuances around in their brain, but I think they should know what the triggers are."