New Guidelines Show Promise in Early Detection of Ovarian Cancer

Exciting news just released in the UK on the fight against ovarian cancer, which causes more deaths than any other reproductive cancer in women. The results of the 14-year study, conducted by a team from University College London and published in the Journal of Clinical Oncology, show that with regular screening and new guidelines, a simple blood test may detect up to 86% of ovarian cancers, twice as effective as traditional methods of detection.

According to the American Cancer Society, over 21,000 women in the US will receive a new diagnosis for ovarian cancer this year. About 14,000 women will die. Ovarian cancer ranks fifth in cancer deaths among women and a woman's chance of getting ovarian cancer is about 1 in 75, and scientists are still unsure what causes the disease.

Although Pap smears are effective at detecting cervical cancer, they are not designed to detect ovarian cancer. On rare occasions, Pap smears will detect cancer of the ovaries, but usually only if the cancer has reached an advanced stage. What makes ovarian cancer such a tricky disease to diagnose is that in its early stages, it rarely causes symptoms. In the absence of symptoms, a doctor would have no reason to order further testing. This is what the UK team hopes to change.

Screening for ovarian cancer traditionally combines transvaginal ultrasound (TVUS) with the CA-125 blood test. TVUS uses sound waves to examine the uterus, fallopian tubes, and ovaries and can detect masses, but cannot differentiate between cancerous and benign tumors. The blood test, which targets a protein in the blood, can be a useful tumor marker, since ovarian cancer usually causes levels of CA-125 to rise. The problem, according to the American Cancer Society, is that many common conditions also cause CA-125 to rise, which may lead to unnecessary surgeries. And not everyone diagnosed with ovarian cancer will have elevated levels of CA-125.

What the UK team is proposing is a combination approach. The researchers believe through annual screening of CA-125 and by tracking trends in a woman's levels over time, early detection of ovarian cancer would be possible. And their results look promising.

Their study showed that one in four ovarian cancers detected was in the earliest stages of development - when there was just a single tumor present or it had just begun to spread through the body (metastasize), according to the BBC. This is a far cry better than waiting for a woman to become symptomatic, which usually occurs once the cancer has progressed.

Another benefit of their approach is gauging the woman's CA-125 levels over time, instead of using a standard elevated value for all women. An upward trend or spike would initiate further testing, perhaps catching the cancer earlier, which would save lives.

For now, researchers are cautiously optimistic. Professor Usha Menon, from University College London told the BBC, "It's good, but the truth lies in whether we've picked up the cancer early enough to save lives. We hope we have."

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