Breakthrough in Ovarian Cancer Screening Holds Promise for Early Detection

By Lisa Collier Cool Sep 20, 2013 89 Recommend

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Recent developments in ovarian cancer screening could help save thousands of lives in the United States each year, suggests a new study published in the journal Cancer. Ovarian cancer is relatively rare, affecting only one in every 2,500 postmenopausal women. However, it remains one of the most deadly forms of gynecological illness. When it is caught early, ovarian cancer is quite treatable, with five-year survival rates approaching 90 percent or more. Unfortunately, it can be difficult to detect in the early stages, leading to potentially life-threatening delays in diagnosis and treatment. As a result, many women are diagnosed after the disease has already progressed to advanced stages. By that point, the chances of survival are much worse, dropping to as low as 18 percent. Fortunately, researchers have tested a new screening strategy that holds promise for early detection. The strategy was found to have a specificity of 99.9 percent, which means that very few patients only 0.1 percent would be falsely diagnosed with cancer. This represents a significant improvement on previously tested approaches to ovarian cancer screening. Crucial Cancer Precautions

Patients sorted by level of risk

Lead by Karen Lu, MD, of The University of Texas MD Anderson Cancer Center in Houston, the researchers tested the new screening strategy among 4051 postmenopausal women in the United States. Over the course of 11 years, participants received annual blood tests checking

for changes in levels of CA-125, a blood protein and known tumor marker. Based on the results of their tests and a calculation called the Risk of Ovarian Cancer Algorithm, the women were divided into three groups: Low-risk participants were given another blood test one year later; intermediate-risk participants were given a follow-up blood test three months later; and high-risk participants were referred to a gynecological oncologist for a transvaginal ultrasound. In total, eighty-five of the participants were identified as high-risk patients and referred to an oncologist. Ten of those women underwent surgery. Four of them had invasive ovarian cancers, two had ovarian tumors with low malignancy potential, one had endometrial cancer, and three had benign ovarian tumors. All of the ovarian cancers were found in early stages. Although the results of this research are promising, the screening strategy is not yet ready for prime time. As Dr. Lu explains: We are currently waiting for the results of a larger, randomized study currently being conducted in the United Kingdom that uses the same Risk of Ovarian Cancer Algorithm in a similar population of women. If the results of this study are also positive, then this will result in a change in practice." Early Signs of Lung Cancer

Women should continue to watch for early symptoms

There are currently no reliable screening tests available for ovarian cancer outside of clinical trials. According to a recent report published on OBGYN.net, past screening strategies have proven ineffective when it comes to reducing mortality and morbidity rates. Moreover, false positive screens have led to too many surgical complications among women who were ultimately found to be cancer-free. The author of that report, Barbara Goff, MD, Director of the Division of Gynecologic Oncology at the Washington School of Medicine, welcomes the results of Dr. Lus study. However, Goff cautions, it will take time for an effective screening test to become widely available.

To stop ovarian cancer in its tracks, Goff encourages women to watch for early symptoms, especially if they have a family history of the disease. Predictive symptoms include abdominal or pelvic pain, difficulty eating or feeling full quickly, increased abdominal size or bloating, and urinary symptoms. Most people with those symptoms are not going to have ovarian cancer, says Goff. We all have those symptoms from time to time. With ovarian cancer, they would be relatively new symptoms so not something the women has had for years and years and they would persist for more than two or three weeks. When symptoms are new and persistent, and particularly when theres more than one symptom, we feel the risk of ovarian cancer is high enough that its worthwhile for clinicians to investigate the cause. If you experience the symptoms described above, speak with your doctor about the risk of ovarian cancer. If you have a family history of ovarian cancer, you may be at greater risk of developing it.