This article is more than 5 years old. Information may no longer be current.
SGO highlights its top five Choosing Wisely recommendations
Click Here to Manage Email Alerts
In an effort to foster conversation between physicians and patients that could highlight common – but potentially unnecessary –aspects of care, the Society of Gynecologic Oncology has outlined five gynecologic oncology-related issues that should be reexamined as part of the Choosing Wisely campaign.
As the physicians charged with treating women with serious gynecologic diagnoses, gynecologic oncologists play a very important role in safeguarding women’s health. And as part of the ABIM Foundation’s Choosing Wisely campaign, the Society of Gynecologic Oncology (SGO) has assessed the tests and procedures that may be overused and/or unnecessary to the goal of keeping women healthy.
The SGO list identifies five targeted, evidence-based recommendations that can support discussions between patients and physicians about what care is really necessary in gynecologic care to ensure survival and quality of life, including:
1. CA-125 or ultrasound screening for ovarian cancer in low-risk patients.
In addition to not leading to earlier detection of or decreased mortality from ovarian cancer in low-risk women, both of these screening tests may lead to false positive results. Along with the stress caused by false positive results, they also lead to unnecessary procedures, which present risks of complication.
2. Pap tests to monitor women with a history of endometrial cancer.
In women who have undergone treatment for endometrial cancer, Pap testing has not been found to provide improved detection of local occurrence. Additionally, false positives can also cause anxiety and unnecessary procedures, such as biopsy and colposcopy.
3. Colposcopy in patients with low-grade pap smear anomalies who have a history of cervical cancer.
In patients who have been treated for cervical cancer whose Pap smears show low-grade squamous intraepithelial lesion or less, colposcopy has not been found to detect recurrence, except in the case of a visible lesion.
4. Routine imaging tests to follow women with gynecologic cancer.
Particularly in asymptomatic women with ovarian, endometrial, cervical, vulvar and vaginal cancers without rising tumor markers, routine imaging for surveillance has not demonstrated efficacy in detecting recurrence or improving survival, according to SGO.
5. Delayed palliation or referral for women with advanced or relapsed cancers.
SGO emphasized the value of delivering palliative care in tandem with cancer directed treatments to women with advanced or recurrent gynecologic cancers. The provision of palliative care, or referral to a palliative medicine specialist, has been found to improve disease symptoms and quality of life.