Screening for ovarian cancer may do more harm than good, the American National Institutes of Health has declared. As a result, American women are unlikely to be offered routine screening for the disease.

This view is in marked contrast to practice in the US where ovarian cancer screening has become a routine procedure, particularly in private gynecological centres. The increase in screening was prompted by the death in 1989 of the comedienne Gilda Radner at the age of 42.

Screening usually involves ultrasound, pelvic examinations and blood analysis, reports the BMJ (23 April, 1994).

The National Institutes of Health says the tests are, at best, unreliable and, at worst, dangerous. Bill Hall, a spokesman for the Institute, explained that the tests are so inaccurate that surgeons have operated on many women who do not have the disease.

Ovarian cancer is also seven times more rare than breast cancer, and it is detected in only a quarter of cases at a stage early enough for effective treatment.

The final concern is cost. If the current three-part test were given to all American women over the age of 45, the US would have to spend $11bn (£7bn) even before calculating in the costs of unnecessary surgery and chemotherapy.

The Institute suggests that only those women over the age of 50 in high-risk groups should be monitored to see if they develop the disease. These groups include women whose relatives have contracted ovarian cancer, women who have had no children, women from North European descent, and those with histories of breast, colon or endometrial cancers.

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Written by What Doctors Don't Tell You

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