New Screening Method Could Double Ovarian Cancer Detection Rates
New research from University College London shows that a new screening technique can detect twice as many women with ovarian cancer, compared to conventional methods.
In a trial originating from part of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), a team led by Usha Menon, a professor and head of the school’s Gynaecological Cancer Research Centre, followed up 46,237 women who continued to receive annual multimodal screening. (A total of 202,638 post-menopausal women age 50 and over took part in UKCTOCS, and were randomly assigned to receive either annual multimodal screening, transvaginal ultrasound, or no test at all.)
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Menon and colleagues found that using a new screening method—which involves interpreting changes in levels of CA125, a protein associated with ovarian cancer, in women’s blood—detected cancer in 86% of women with invasive epithelial ovarian cancer, in comparison to conventional techniques used in previous trials (41%) or clinical practice (48%).
Using a computer algorithm, the investigators calculated their risk of ovarian cancer according to the patient’s age, original CA125 levels, and how those levels had changed over time. The team then estimated ovarian cancer risk by comparing the serial pattern with known cases of cancer and controls. Among those receiving multimodal screening, 640 had undergone surgery for suspected cancer, with 133 of them having developed epithelial ovarian cancers. An additional 22 participants were diagnosed with epithelial cancer within 1 year of their final annual screen, according to the authors, who note that they will receive results on the impact of screening on ovarian cancer deaths later this year.
While “we have not used the [risk of ovarian cancer algorithm] in the setting of symptomatic patients, the findings suggest that CA125 change with time is important in the context of ovarian cancer,” says Menon.
“There is clear evidence,” says Menon, “that rising levels precede clinical recurrence in women with ovarian cancer who are in remission. And now we see it is also useful in early detection.”
Extrapolating current findings suggest repeating CA125 in 6 to 12 weeks if symptoms persist,” adds Menon, “and there is no definitive diagnosis. Rising levels should trigger further evaluation.”
Menon U, et al. A risk algorithm using serial biomarker measurements doubles the number of screen-detected cancers compared to a single threshold rule in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Journal of Clinical Oncology. 2015.