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New Test for Early-Stage Ovarian Cancer

Study Shows That New Way of Evaluating a Protein Blood Test Could Detect Ovarian Cancer
By
WebMD Health News
Reviewed by Louise Chang, MD

March 10, 2009 -- A blood test to detect elevated levels of the protein CA125 -- combined with ultrasound -- may prove to be an effective screening strategy for ovarian cancer in its earliest and most treatable stages, new research suggests.

Very early findings from the largest randomized ovarian cancer screening study ever conducted are promising, researchers say.

But it will be several years until it is clear if the screening method evaluated in the trial saves lives.

More than 200,000 postmenopausal women in the U.K. are participating in the study, which will end in 2014.

"These early results show that screening is feasible," study researcher Usha Menon, MD, of the University College London tells WebMD. "But we don't yet know if this screening saves lives and if so, at what cost. The hope is that we will have these answers in 2014."

Most Ovarian Cancers Found Late

Ovarian cancer is highly treatable when detected early, with a survival rate of 92% at least five years after being diagnosed. But more than two out of three patients are diagnosed with advanced-stage disease, when the five-year survival rate is only 20% to 30%.

More than 21,000 new cases of ovarian cancer were diagnosed in the U.S. in 2008, and more than 15,000 women died from the disease, according to American Cancer Society.

This is why the stakes are so high for the development of an effective screening strategy to detect ovarian cancer in its earliest stages, Menon says.

The CA125 blood test, first developed in the early 1980s, measures a protein that is elevated in ovarian cancer patients. The second generation of the test has proven useful for evaluating how well patients respond to ovarian cancer treatments.

But its usefulness as a screening tool to detect ovarian cancer is more controversial because false-positive rates tend to be high, leading to unnecessary follow-up testing and surgery.

In the U.K. study, researchers evaluated a new way of using the CA125 blood test, which they hope will prove more useful for diagnosing the disease.

Traditionally, a CA125 level of 35 or above has been considered elevated and a level of CA125 below this has been considered normal.

But in the risk-assessment model developed by Menon and colleagues, a woman's absolute CA125 level is less important than changes in CA125 from year to year. Age is also considered, since ovarian cancer risk increases with age.

CA125 Plus Ultrasound

The ongoing U.K. study includes 202,638 postmenopausal women between the ages of 50 and 74 at recruitment between 2001 and 2005 who were randomly assigned to undergo no screening, annual screening with ultrasound alone, or annual screening with ultrasound and the CA125 blood test for 10 years.

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