Study Shows Promise for Ovarian Cancer Screening

Researchers from the United Kingdom have found that screening women for ovarian cancer may reduce deaths, but they caution that more study is needed to confirm their results. In one of the biggest trials of its type, the researchers studied more than 200,000 women aged 50 – 74 years in England, Northern Ireland, and Wales. After an average follow-up of 11 years, the trial concluded that ovarian cancer screening may reduce deaths by an estimated 20%. The study was published December 17, 2015 in The Lancet.

Finding a way to accurately detect ovarian cancer in its early stages could save many women’s lives, because survival rates are much higher when the disease is caught early. But currently, there is no proven strategy for early detection, and symptoms of the disease often don’t appear until the cancer has spread and is harder to treat.

Part of the challenge of developing a screening strategy is the need for a test that is very accurate, both in helping to determine which women have ovarian cancer and which do not. Diagnosing ovarian cancer requires surgery to remove the ovaries. A screening test with as few false positives as possible would reduce the number of unnecessary operations.

Blood test and ultrasound

Previous studies have looked at screening using a blood test for the CA 125 protein, which is a tumor marker often elevated in women with ovarian cancer, combined with an ultrasound exam of the ovaries. But those studies did not demonstrate a clear benefit to screening.

The United Kingdom study was much larger and the follow-up period was longer. The researchers used a computer program called the Risk of Ovarian Cancer Algorithm (ROCA) to calculate the risks and benefits for women to be screened for ovarian cancer. The algorithm is based on age, risk status, and CA-125 levels over time. As a result of the study, the authors estimate that 641 women need to be screened regularly for 14 years to save one life from ovarian cancer. However, several women had false positive results which led to unnecessary surgeries and some serious medical complications.

The future of screening

The study’s authors say more research is needed to refine and confirm their screening strategy before it could be safely implemented. It is not currently recommended by the American Cancer Society, the United States Preventive Services Task Force, or any other large medical organization for routine screening.

However, the American Cancer Society will consider the new evidence from this study as part of its ongoing guidelines development process. According to Robert Smith, PhD, American Cancer Society Vice President, Cancer Screening, the results of this study have been eagerly awaited for many years and the guidelines committee will be closely monitoring ongoing evaluation of the data.

Smith said, “The findings mean there is renewed urgency to determine if and when screening for ovarian cancer might be recommended.”

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomized controlled trial. Published December 17, 2015 in The Lancet. First author Ian J. Jacobs, FRCOG, University College London, London.

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