You are here

New Ovarian Cancer Screening Test Reduces Mortality

Deaths drop by 20% after 11 years of follow-up

Results from the UK Collaborative Trial for Ovarian Cancer Screening (UKCTOCS), a large prospective randomized controlled study of more than 200,000 initially cancer-free, postmenopausal women 50 to 85 years of age, have been published in The Lancet. The findings demonstrate that screening may reduce ovarian cancer mortality by an estimated 20% after a median follow-up period of 11 years.

Study participants were randomly assigned to a control group (n = 101,299) who received no screening and a screening group (n = 101,247). The screening group was divided into two arms: a multimodal screening (MMS) group (n = 50,624) and an ultrasound screening (USS) group (n = 50,623). Women in the MMS group underwent a blood test to assess levels of cancer antigen 125 (CA-125), and the outcomes of these tests were evaluated with the Risk of Ovarian Cancer Algorithm (ROCA, Abcodia Ltd) to assign a woman’s level of disease risk. If the risk was classified as intermediate or elevated on ROCA, repeat blood tests and/or a transvaginal ultrasound (TVUS) scan of the ovaries was used. Women with an intermediate classification were referred for a repeat CA-125 test in 12 weeks and were administered a TVUS scan if they received three intermediate ROCA scores. Women assessed with advanced risk received a TVUS scan within 6 to 8 weeks without additional blood testing.

Ovarian cancers were diagnosed in 630 (no screening), 338 (MMS), and 314 (USS) women. A Cox statistical analysis indicated mortality reductions over years 0 to 14 of 15% with MMS and 11% with USS, which were not significant. This mortality reduction consisted of 8% and 23% relative reductions during years 0 to 7 and years 7 to 14, respectively, in the analysis of MMS versus no screening (the reduction during  years 7 to 14 was statistically significant) and of 2% and 21%, respectively, in the USS group. The median follow-up period was 11.1 years.

An additional statistical analysis was performed after excluding women who had undiagnosed ovarian cancer when they joined the study. This analysis demonstrated that there was a significant reduction in deaths, with an average mortality reduction of 20% overall and 28% in years 7 to 14. There was also a significant reduction in deaths in the MMS group compared with the no screening group using a separate analysis.

The trial results suggested that approximately 15% of ovarian cancer deaths could be prevented for every 10,000 women who attend a screening program that involves annual blood tests for between 7 and 11 years.

The study findings also confirmed previous results showing that, on average, for every three women who underwent surgery as a result of an abnormal screen, one woman had ovarian cancer and two women did not. For those who had surgery, approximately 3% had major complications.

Previous studies have shown that 92% of women diagnosed with stage 1 ovarian cancer survive for 5 or more years, compared with only 18% of women diagnosed with stage 4 disease. Because ovarian cancer often has nonspecific symptoms or no symptoms, women are usually diagnosed with advanced (stage 3 or 4) disease.

Source: PR Newswire; December 17, 2015.

Recent Headlines

Despite older, sicker patients, mortality rate fell by a third in 10 years
Study finds fewer than half of trials followed the law
WHO to meet tomorrow to decide on international public heath emergency declaration
Study of posted prices finds wild variations and missing data
Potential contamination could lead to supply chain disruptions
Declining lung cancer mortality helped fuel the progress
Kinase inhibitor targets tumors with a PDGFRA exon 18 mutation
Delayed surgery reduces benefits; premature surgery raises risks
Mortality nearly doubled when patients stopped using their drugs