American College of Obstetricians and Gynecologists

View all recommendations from this society

Released March 14, 2016

Don’t perform pelvic ultrasound in average risk women to screen for ovarian cancer.

Although the mortality rate associated with ovarian cancer is high, the disease occurs infrequently in the general U.S. population, with an age-adjusted incidence of 13 cases per 100,000 women. As a result, the positive predictive value of screening for ovarian cancer is low, and most women with a positive screening test result will have a false-positive result. Annual screening with transvaginal ultrasonography in women does not reduce the number of ovarian cancer deaths.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

As a national medical specialty society, the American College of Obstetricians and Gynecologists relies on the input of any number of its committees in the development of various documents. In the case of the items submitted for the Choosing Wisely® campaign, input from the following committees was solicited: the Committees on Patient Safety and Quality Improvement; Obstetric Practice; and Gynecologic Practice. A literature search was conducted related to the initial list of approximately ten items. We then sent this list to the College’s Executive Board and asked them to select five of the items based on their potential to improve quality and reduce cost. We explained to them that the items were written to avoid complex or clinical terminology, but not at the risk of reducing the value and credibility of the recommendations made. In the case of the first two items on our list – “Don’t schedule elective, non-medically indicated inductions of labor or Cesarean deliveries before 39 weeks 0 days gestational age” and “Don’t schedule elective, non-medically indicated inductions of labor between 39 weeks 0 days and 41 weeks 0 days unless the cervix is deemed favorable” – we collaborated with the American Academy of Family Physicians in developing the final language. A list of the second set of “five items” was selected by the Committee on Patient Safety and Quality Improvement before submission to the College’s Executive Board for approval. Any comments received from the Executive Board were incorporated into the final list that was approved.

The College’s disclosure and conflict of interest policy can be found at www.acog.org.

Sources

Moyer VA. Screening for ovarian cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. U.S. Preventive Services Task Force. Ann Intern Med 2012;157:900–4.

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. Committee Opinion No. 477: the role of the obstetriciangynecologist in the early detection of epithelial ovarian cancer. Obstet Gynecol. 2011 Mar;117(3):742-6.

U.S. Preventive Services Task Force. Ovarian cancer: screening. Rockville (MD): USPSTF; 2012. Available at: http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/ovarian-cancer-screening. Retrieved December 9, 2015.