Page last updated at 00:46 GMT, Wednesday, 11 March 2009

Trials offer ovarian cancer hope


Rocky Scott explains how screening caught her Ovarian cancer

Screening might help to detect ovarian cancer before symptoms develop, early results from a UK trial suggest.

Some 83% of cancers were picked up, with almost half the tumours discovered at an early stage.

The disease is 90% curable when treated early, but because symptoms do not emerge until later it is often not detected until it is more advanced.

However, the Lancet Oncology study stresses it is too early to determine whether screening will save lives.

Fourth most common cause of cancer death in UK
Nearly 7,000 diagnoses and nearly 4,500 deaths a year
Survival rate when diagnosed in early stages: up to 90%
Survival rate when diagnosed in later stages: 30%
Early detection is complex as signs and symptoms of ovarian cancer are easily mistaken for other, more common and less serious conditions
The average GP only sees one case of ovarian cancer every five years

Experts analysed data from the first stage of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) trial, which will assess over the next five years whether a national screening programme is a good idea.

Among the 100,000 post-menopausal women who took part, screening detected 58 cancers, but missed the disease in another 12 women.

Lead researcher Professor Ian Jacobs, director of the University College London Institute for Women's Health, said: "There is a long way to go before we have firm evidence as to whether or not screening is able to detect cancer early enough to save lives.

"It will also be essential to balance any benefits offered by screening with the downside, as it is recognised that screening can cause anxiety and lead to some unnecessary operations.''

Two methods

Two screening methods are being used in the UKCTOCS trial: a blood test or an ultrasound scan.

Any of the following symptoms, if they occur on most days may suggest ovarian cancer:
Persistent pelvic and abdominal pain
Increased abdominal size/persistent bloating
Difficulty eating, and feeling full quickly

The blood test measures levels of a protein called CA125 that is often elevated in the blood of women who have ovarian cancer.

The ultrasound scan, which is carried out internally, is used to look for abnormalities in the ovaries.

In the blood test group 34 out of 38 cancers were detected, an accuracy rate of 89%. In total, 97 women in this group underwent surgery to remove their ovaries

In the ultrasound group 24 out of 32 cancers were detected, and accuracy rate of 75%. However, this test threw up a much higher number of "false positive" results, with a total of 845 women undergoing surgery to remove their ovaries.

The researchers believe this was partly due to ultrasound picking up benign ovarian cysts.

The research team found both methods of screening were encouragingly sensitive.

But Professor Jacobs admitted the level of "false positive" results did give some cause for concern.

Ovarian cancer
Ovarian cancer can be difficult to spot

Dr Usha Menon, who is co-ordinating the trial, said: "The early results suggest that both types of screening can be used on a large scale and both successfully identify ovarian cancers.

"However, we must wait till 2015 before we can conclude whether or not a wider screening programme could lead to a fall in deaths due to ovarian cancer."

Peter Reynolds, of the charity Ovarian Cancer Action, described the findings as "encouraging".

"However, the trial still has several years until completion and the researchers will need to assess mortality rates to get a clearer idea of how effectively these screening methods translate into saving lives."

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