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Benefits of early detection of ovarian cancer are overestimated
Health experts say that ovarian cancer is more dangerous than breast cancer because the death rate is much higher with the former type of cancer. Prevention and early detection are therefore of particular importance. But researchers believe gynecologists overestimate the benefits of ovarian cancer screening - and underestimate its harm.
Ovarian cancer is one of the most aggressive tumors
"Ovarian cancer (ovarian cancer) is one of the most aggressive tumors and is the second most common malignant disease of the female genital organs," wrote the German Cancer Society on its website. "The great danger with this type of tumor is that it is usually discovered very late because there are no symptoms for a long time," said the experts. Early detection is therefore of particular importance. But the benefits of such investigations are overestimated according to experts.
Doctors stick to medical measures without any benefit
As the Max Planck Institute (MPI) for Educational Research writes in a communication, evidence-based medicine requires that doctors use the best available scientific study currently available to make good treatment decisions.
However, previous research shows that this is not always the case in practice. For example, doctors sometimes adhere to medical measures that have been shown to be of no use and may even be harmful.
This is also the case with early ovarian cancer detection, as an online study by the Max Planck Institute for Educational Research with more than 400 US gynecologists shows.
The results were published in the scientific reports.
Medical associations do not recommend early detection
In the past few years, two large randomized-controlled clinical studies have concluded that early detection of ovarian cancer does not save additional lives, but that it can be associated with massive damage, such as unnecessary ovarian extraction in healthy women.
According to the MPI, early detection is therefore not recommended by medical associations.
An online study by the Max Planck Institute for Human Development with 401 US gynecologists shows that almost 60 percent of doctors still recommend early detection.
The majority of gynecologists do not know the actual benefit or harm of early detection. As a result, they cannot provide patients with comprehensive information.
Misconceptions about effectiveness
"Not only patients have wrong ideas about the effectiveness of early cancer detection, but also doctors," says lead author Odette Wegwarth from the Max Planck Institute for Human Development.
"An earlier study suggests that one reason for this is that many doctors are insufficiently prepared in their training to correctly interpret the statistics used to describe the benefits and harms," said the scientist.
The aim of the current study was to investigate whether gynecologists recommend early detection of ovarian cancer despite a recommendation from the medical professional associations, and whether this is related to their level of knowledge regarding the benefits and harm of early detection.
In addition, the researchers investigated whether the gynecologists revised the incorrect benefit or damage assessment after the current evidence was presented in an easily understandable form.
German doctors also have a poor level of knowledge
According to the experts, it was found that the majority of gynecologists overestimated the benefits of early detection and massively underestimated the damage caused by early detection. Depending on the question, this was 45 to 97 percent of the respondents.
The misjudgment was particularly pronounced in those almost 60 percent of gynecologists who routinely recommended early diagnosis.
Presenting an evidence-based, easy-to-understand fact box resulted in 52 percent revising their erroneous estimates; 48 percent, however, do not.
"Our study shows that recommending early detection without benefit is associated with inadequate knowledge of the evidence," says Wegwarth.
"For doctors who are open to evidence-based medicine, easily understandable, clear formats of risk communication can help. Obviously we cannot reach all of them with a transparent representation. The reasons for this need to be researched further. "
The fact that the study was carried out with US doctors does not mean that the problem is only limited to the American healthcare system.
"We have a sound study base that German doctors also have a poor level of knowledge when it comes to screening-related statistics and the effectiveness of early detection," explains Wegwarth.
"Strengthening evidence-based medicine in practice can therefore only be achieved if we prepare doctors well in their training and, above all, in a practical manner to deal with statistics," said the study author. (ad)