Women at high risk of developing ovarian cancer should be screened every four months, recent research suggests.
The study, “Evidence of Stage Shift in Women Diagnosed with Ovarian Cancer during Phase II of the United Kingdom Familial Ovarian Cancer Screening Study,” appeared in the Journal of Clinical Oncology.
Ovarian cancer is usually detected in later stages when the prognosis is poor. Yet when detected early using regular biomarker tests, the prognosis is excellent.
Genetic mutations in BRCA1 and BRCA2 and Lynch syndrome (LS) are associated with a high risk for ovarian cancer: BRAC2 carriers are 11 to 37 percent likely to develop the disease by age 70, and BRCA1 carriers are at to 65 percent risk of developing the disease, according to the study.
Doctors recommend that high-risk women have their ovaries and fallopian tubes removed after completing their families or going through natural menopause. Yet many women either delay surgery or decline it altogether.
Now, University College London’s UK Familial Ovarian Cancer Screening Study (UK FOCSS) concludes that screening high-risk women every four months with the Risk of Ovarian Cancer Algorithm (ROCA) may be an option until they choose surgery.
ROCA, a test licensed to UCL spinoff Abcodia, looks for increasing levels of the CA 125 protein in the blood, which is usually high in women with ovarian cancer.
The study included 4,348 women with a one in 10 or greater risk of developing ovarian cancer or fallopian tube cancer (FTC), due to family history or a faulty gene. All the women had declined surgery, and all underwent ROCA screening every four months.
Over a median follow-up of 4.8 years, 19 women were diagnosed with invasive OC/FTC within one year of prior screening. The screening picked up nine out of every 10 cancers.
A further 18 women were diagnosed with ovarian cancer in the ensuing five years; 17 of them had advanced stage cancer (IIIB-IV), compared to seven of the 19 diagnosed during the screening period.
“I am delighted that this phase of the 20-year UK FOCSS research effort suggests there is a role for ovarian cancer screening in women at high risk,” Ian Jacobs, the study’s principal investigator, said in a news release.
“The screening appears to be very effective at detecting ovarian cancer before it causes symptoms,” added Adam Rosenthal, clinical lead on the trial, UCL EGA Institute for Women’s Health. “The proportion of women who had all their tumors removed was very high, which is important in terms of predicting a better outcome.”