Don’t get a whole-body PET-CT or tumor marker panel just because you have no symptoms

When people without symptoms get screened, what turns up most often is a false alarm. Over eight in ten who get a whole-body CT have at least one “abnormality” noted, and nearly four in ten are called back for more tests, yet most findings are benign. Women screened with ovarian-cancer markers do not die less of ovarian cancer, and some have had surgery for nothing after a false alarm.

Cost

A whole-body PET-CT costs roughly 7,000–10,000 RMB per scan and exposes you to ionizing radiation. Tumor marker panels cost a few hundred RMB. The real cost comes later: if a test flags an “abnormality” that turns out to be a false positive, you’ll need follow-up tests, biopsies, and possibly surgery — all of which add up financially and physically.

Benefit

The USPSTF, which evaluates preventive measures in the U.S., gave a D rating to using CA-125 and ultrasound to screen asymptomatic women for ovarian cancer — meaning it does not recommend this screening. Their basis is the PLCO trial, which showed a 0.34% death rate from ovarian cancer in the screened group versus 0.29% in the control group (RR 1.18, 95% CI 0.82–1.71). Screening offers no real benefit. The rate of unnecessary surgery due to false positives ranges from 0.2% to 3.25% across studies, with up to 15% of those patients experiencing serious complications. Another study screened 1,192 symptom-free individuals with whole-body CT; 86% had at least one “abnormality” noted, and 37% were advised to undergo further tests. Most of these findings were benign. The idea that screening is “worth it” because it enables early detection stems largely from intuition rather than solid evidence.

Notes

The tumor marker portion of this recommendation is supported by randomized controlled trials. In contrast, the evidence for whole-body CT and PET-CT relies mainly on observational follow-ups without proper control groups, so it falls to a B rating. Other proven screening methods — such as tests for colorectal and cervical cancer, breast cancer screening, or low-dose chest CT for high-risk individuals — are discussed in Section 1. For people already showing symptoms or diagnosed with cancer, PET-CT is a diagnostic tool, not a screening measure, and is handled separately.

Sources · 2

1. US Preventive Services Task Force (2018). Screening for Ovarian Cancer: US Preventive Services Task Force Recommendation Statement. JAMA（同一份建议另有 USPSTF 官方页）. doi.org/10.1001/jama.2017.21926、uspreventiveservicestaskforce.org/uspstf/reco…
2. Furtado CD et al. (2005). Whole-body CT screening: spectrum of findings and recommendations in 1192 patients. Radiology. doi.org/10.1148/radiol.2372041741