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New Screening Strategy May Detect Ovarian Cancer at Early Stages

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Key Points

  • A new screening strategy for ovarian cancer appears to be highly specific for detecting the disease before it becomes lethal.
  • Findings from the study by investigators at UT-MD Anderson Cancer Center indicate that this screening strategy achieves high specificity with very few false-positive results in postmenopausal women.
  • Investigators are waiting on results of a larger clinical trial now ongoing in the UK to determine whether the new strategy will result in a change in practice.

A new screening strategy for ovarian cancer appears to be highly specific for detecting the disease before it becomes lethal. The strategy was described in a study published early online this week in Cancer. A clinical trial is ongoing to verify the findings.

Karen Lu, MD, of The University of Texas MD Anderson Cancer Center in Houston, led a team that tested the potential of a two-stage ovarian cancer screening strategy that incorporates changes in CA125, a known tumor marker. In their 11-year study, 4,051 postmenopausal women initially underwent an annual CA125 blood test.

Risk of Ovarian Cancer Algorithm

Based on a calculation called the “Risk of Ovarian Cancer Algorithm,” women were divided into three groups: those who should receive another CA125 test 1 year later (low risk), those who should receive a repeat CA125 in 3 months (intermediate risk), and those who should receive a transvaginal ultrasound and be referred to a gynecologic oncologist (high risk).

An average of 5.8% of women were found to be of intermediate risk each year, meaning that they should receive a CA125 test in 3 months. The average annual referral rate to transvaginal ultrasound and review by a gynecologic oncologist was 0.9%. Ten women underwent surgery based on their ultrasound exams, with four having invasive ovarian cancers, two having ovarian tumors of low malignant potential, one having endometrial cancer, and three having benign ovarian tumors. This equates to a positive predictive value of 40% for detecting invasive ovarian cancer. The specificity of the testing strategy was 99%, meaning that only 0.1% of patients without cancer would be falsely identified as having the disease. Importantly, all of the ovarian cancers were early-stage.

High Specificity, Few False-Positives

The findings indicate that this screening strategy achieves high specificity with very few false-positive results in postmenopausal women. “The results from our study are not practice-changing at this time; however, our findings suggest that using a longitudinal screening strategy may be beneficial in postmenopausal women with an average risk of developing ovarian cancer,” said Dr. Lu.

Dr. Lu added, “We are currently waiting for the results of a larger, randomized study 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.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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