Physician Practices and Beliefs about Ovarian Cancer Screening in High-Risk Patients

Abstract

Screening with transvaginal ultrasound and CA-125 is often recommended patients with pathogenic variants in the BRCA1 or BRCA2 genes despite evidence showing that screening does not result in mortality benefits. To better understand physician’s attitudes and beliefs about ovarian cancer screening, including whether and why they recommend ovarian cancer screening to high-risk patients, we conducted semi-structured interviews with physicians knowledgeable about hereditary cancer prevention. The most important themes we identified in our conversations with physicians were that physicians have open conversations with patients about their desires related to surgery to make personalized recommendations that are best suited to each patient and their unique goals, there are many challenges to managing ovarian cancer risk, and it is reasonable to believe that a population wide approach to predictive genetic testing for ovarian cancer could save lives. Our results indicate there is more research needed to identify novel methods of ovarian cancer screening and to gain an understanding of the impacts of risk reducing surgery. There is also a need to increase support for patients, helping them get access to genetic testing and the appropriate subsequent care.