Ovarian Cancer Screening Practices of Obstetricians and Gynecologists in Puerto Rico

Abstract

Background. Ovarian cancer is the most fatal malignancy of the female genital tract and is associated with high mortality. The American Congress of Obstetricians and Gynecologists (ACOG) and the United States Preventive Services Task Force (USPSTF) recommend against screening for ovarian cancer in asymptomatic, average-risk women. Objective. To assess the ovarian cancer screening practices in asymptomatic, average-risk women among obstetricians and gynecologists (Ob/Gyn) in Puerto Rico. Methodology. From 2011 to 2012, self-administered anonymous questionnaires were mailed to all licensed obstetricians and gynecologists in PR. Results. Response rate was 25%. Overall, 53.9% were screening for the disease. Reported screening methods were CA-125 and transvaginal ultrasound (TVUS), 39.2%, TVUS only, 30.4%, and CA-125 only, 9.8%. In the logistic regression model, the odds that a given health practitioner routinely screened for ovarian cancer in the asymptomatic, average-risk population increased by 8% with every unit increase in his or her years in practice. Conclusion. The majority of the practicing Ob/Gyn in PR who participated are not following the guidelines established by the ACOG and the USPSTF for ovarian cancer screening.

Prevalence of breast and ovarian cancer subtypes in Hispanic populations from Puerto Rico

“…Although transvaginal ultrasounds and serum CA-125 levels have been evaluated as screening methods for OC, they have not proven effective and do not improve survival rates [ 24 ]. In Puerto Rico, a study focused on OC screening practices among gynecologists/obstetricians in the island showed that 53.9% performed OC screening on asymptomatic patients, contrary to the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncology guidelines that do not recommend screening in low risk women [ 25 ]. Similar to our study, another investigation compared ethnic disparities among OC patients in the US and reported that the majority of the Hispanic cases (including Puerto Rican women) had a higher proportion of serous tumors and grade 3 classification [ 23 ].…”

Using transvaginal ultrasound to determine the cause of chronic pelvic pain

“…Incidentally, TVU has found ovarian cancer in individuals without symptoms as frequently as 30.4%. 11 Due to its low predictive value, TVU must be used in conjunction with serologic testing, such as CA-125. 10 When used in conjunction with a serum tumor marker such as CA-125, TVU offers a diagnostic value with a sensitivity of 90.63%, specifi city of 97.14%, positive predictive value of 93.94%, and negative prediction of 98.55% for ovarian cancer.…”

Polymer-Based Terbium Complex as a Fluorescent Probe for Cancer Antigen 125 Detection: A Promising Tool for Early Diagnosis of Ovarian Cancer

“…While tumor markers, imaging techniques, and combined algorithms have been employed to differentiate benign from malignant epithelial OC, the search for improved sensitivity and specificity continues. , CA-125, the most commonly used biomarker for OC detection, faces limitations . While elevated levels in advanced stages make it valuable for postsymptomatic detection, its ambiguous results in early stages have led medical societies to advise against routine screening for average-risk women. , Despite its limitations, CA-125 remains crucial for monitoring treatment response, disease-free survival duration, and predicting prognosis. − The standard enzyme-linked immune sorbent assay (ELISA) method, while established, has limitations . The ELISA encounters three main limitations; first, the interfering compounds in the sample matrices can adversely impact the accuracy and precision of the assay.…”

“… 13 While elevated levels in advanced stages make it valuable for postsymptomatic detection, its ambiguous results in early stages have led medical societies to advise against routine screening for average-risk women. 14 , 15 Despite its limitations, CA-125 remains crucial for monitoring treatment response, disease-free survival duration, and predicting prognosis. 16 − 22 The standard enzyme-linked immune sorbent assay (ELISA) method, while established, has limitations.…”