Many women with ovarian cancer are not diagnosed until the disease is in its advanced stages, limiting treatment options and increasing the risk of death.

In the April 2009 issues of The Lancet Oncology, investigators from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) report that initial data from their study has established that screening strategies for ovarian cancer are feasible

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In UKCTOCS, a total of 202,638 post-menopausal women aged 50 to 74 were randomly assigned to one of three groups – no treatment, annual screening with a CA125 blood test and then transvaginal ultrasound if the CA125 was abnormal, or annual screening with transvaginal ultrasound only. CA125 is a tumor marker, and its levels in the blood are usually increased among women with ovarian cancer. Women who had an abnormal screen had repeat tests, and those who had persistent abnormalities underwent clinical evaluation and further treatment, including surgery, as necessary. Of the 50,078 women who underwent CA125 testing and, if necessary, follow-up transvaginal ultrasound, 4,355 (or 8.7%) required a repeat test. Of the 48,230 who underwent transvaginal ultrasound only, 5,779 required a repeat test. A total of 42 ovarian and tubal cancers were detected among the CA125 and follow-up transvaginal ultrasound group, and a total of 45 cancers were detected among the ultrasound only group. And, an additional 13 women developed ovarian cancer during the year after the screening test(s) were performed.

Based on these data, the researchers concluded that the ability of both screening strategies to positively identify ovarian cancer was encouraging. The ability of the CA125 and follow-up transvaginal ultrasound screen to definitively rule out ovarian cancer was somewhat higher than that of the transvaginal ultrasound alone. Now, the researchers are awaiting results of ongoing screening to evaluate the effect of ovarian cancer screening on mortality.

Source: The Lancet Oncology. 2009;10(4):327-340.