New hope for early ovarian cancer detection?
A US trial of 4,000 women suggests it is possible to screen for ovarian cancer at an early stage, raising the potential of saving those at risk from the hard-to-detect disease.
Twelve women die of ovarian cancer every day in the UK – a rate that has remained consistent over the past 20 years.
But a US trial of a screening trial in the early stages of the disease showed that ovarian tumours can be identified through a blood test and internal ultrasound exam, with a low rate of incorrect diagnoses.
Ovarian cancer is the fifth most common cancer to affect women, but it has a high fatality rate because there are so few signs of the disease and it tends to be detected at a late stage.
The survival rate of ovarian cancer is 90 per cent if it is caught early. This drops to 30 per cent if it is discovered in its later stage.
One in 12 women die of ovarian cancer every day in the UK.
The University of Texas study was small, with only 4,051 women involved over 11 years. However the technique used to carry out early-stage screening is similar to that being tested in a large-scale UK study involving 300,000 women, which will be complete in 2015.
The US researchers assessed the levels of CA125 in women’s blood – and crucially, took age into consideration and monitored levels over a period of time. Previous trials using this method were found to be ineffective, and many women had unnecessary operations, because CA125 levels can be raised by other causes, including heart problems.
Tests over time
Women taking part in the study were given an annual CA125 blood test, then a “Risk of Ovarian Cancer Algorithm” (ROCA) calculation was used to divide them into three groups depending on what risk they were at. Those women at intermediate risk repeated the test three months later, and only those deemed to be at a high-risk went on to see a specialist and have an ultrasound.
All the cancers that developed were detected at an early stage, and ten women had surgery based on their ultrasound scan.
This trial was found to demonstrate “excellent specificity and positive predictive value” and the results were published in Cancer, the American Cancer Society journal.
“I’ve become an admitted sceptic of ovarian cancer screening,” said Professor Karen Lu, M.D. one of the study’s authors.
“Now, with these findings, I’m cautiously optimistic that in the not too distant future, we may be able to offer a screening method that can detect the disease in its earliest, curable stages and make a difference in the lives of women with this now-devastating disease.”
