New Hope for Early Detection of Ovarian Cancer08/26/13
MONDAY, Aug. 26 (HealthDay News) -- A simple blood test combined
with an ultrasound exam may help doctors catch ovarian cancer while
it's still treatable, a new study shows.
Ovarian cancer is a silent killer. It strikes with few, if any,
symptoms. By the time a woman knows she has it, the cancer is often
advanced and the outlook grim.
This new study "is a ray of excitement," said researcher Dr.
Karen Lu, a professor of gynecologic oncology at the M.D. Anderson
Cancer Center in Houston. "The important message is that this
shouldn't change clinical practice right now. We don't have enough
Unlike breast, cervical or colon cancer, there's no reliable
screening test to detect the disease. Many approaches to ovarian
cancer screening have been tried, but none has proven accurate
enough to use in the general population. Most produce high numbers
of false positive results, which require doctors to perform
invasive surgeries to rule out cancer.
Because ovarian cancer is rare -- about 1 in 2,500
postmenopausal women in the United States will receive an ovarian
cancer diagnosis in their lifetime -- any screening test that
produces many false positives would harm far more women than it
would help, making doctors very cautious about the tests they
In the new study, which ran for 11 years and included more than
4,000 women, most of whom were white, a two-stage screening method
appeared nearly 100 percent accurate at ruling out these harmful
false alarms in postmenopausal women.
A much larger study -- of more than 200,000 women -- testing the
two screening methods is under way in the United Kingdom.
Preliminary results from that trial, released in 2009, were
positive, and researchers are eagerly awaiting the final results,
which are due in 2015.
"We really need to wait for the U.K. data before we're able to institute this as a screening method," Lu said.
The new screening method combines two existing tools: a blood
test that measures a protein shed by tumor cells called CA-125 and
an ultrasound exam to give doctors a look at the ovaries.
Those two tests have been used together before, with
disappointing results. But the current research differs in that it
takes into account fluctuations in a woman's blood test results.
The important thing isn't any single measure of CA-125 in the
blood, but how it changes over time, the researchers said.
For the new study, published online Aug. 26 in the journal
Cancer, the researchers recruited post-menopausal women
between the ages of 50 and 74 who had no personal or family history
of ovarian cancer. Women were screened, on average, for about four
Each year, women in the study were given a CA-125 blood test.
Researchers fed the women's age and test results into a
mathematical formula called Risk of Ovarian Cancer Algorithm, or
ROCA, which was developed using a database of CA-125 test results
from thousands of women in the United States and Sweden.
If the results came back as low risk, women were asked to repeat
the test the following year. Women with intermediate-risk results
were told to have another blood test in three months, while those
with high-risk results were referred for a transvaginal ultrasound
exam, a pain-free test that lets doctors see the size and shape of
If the ultrasound results also were abnormal, women were
referred to surgery.
Over 11 years, 83 percent of women remained at low risk and had
to return only for an annual blood test. About 14 had at least one
intermediate-risk result that caused them to return in three months
for a follow-up test. Roughly 3 percent were deemed high risk and
were referred for an additional ultrasound exam.
Ten of the 117 women referred for ultrasound exams had
suspicious results and underwent subsequent surgeries. Of those,
seven had some type of cancer, while three had benign tumors. Four
of the patients had early stage cancers. All of the women are still
alive and free of disease following treatment for their
One expert said these results, along with the early results
achieved in the British trial, are very promising.
"I was more excited reading this study than I have been in a really long time," said Debbie Saslow, director of breast and gynecologic cancers for the American Cancer Society in Atlanta.
"Not only was [the screening] finding cancers in both of those studies, but it was finding them early," Saslow said. "That's what we want to do."
Saslow pointed out that the study was small, however, and it had
no control arm to help researchers see what would have happened to
a similar group of women who were not screened over the same time
Whether the findings would apply to younger women or blacks and
Hispanics also is unknown.
For more information on ovarian cancer, head to the
U.S. National Cancer Institute.
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