New Screening Technique for Ovarian Cancer
Study Shows New Approach May Have Potential to Screen for Early-Stage Ovarian Cancer
Testing CA-125 continued...
On an annual basis, less than 1% of the women were categorized as high risk of ovarian cancer based on their change in CA-125 levels and referred for TVS.
About 7% of women were categorized as being at intermediate risk -- "their CA-125 levels went up slightly," Lu says -- and told to come back for CA-125 screening every three months.
"So over 90% of women were low risk and just had to come back for CA-125 screening annually," she says.
Of the 85 women categorized as high risk over the course of the study, eight went on to have surgery.
Three of the eight had early-stage aggressive ovarian cancers, "the kind that I as a doctor want to pick up early," Lu says.
"All three women with invasive ovarian cancers had at least three years of low-risk annual CA-125 values prior to a rising CA-125," she adds.
Two women had borderline ovarian tumors, two had benign ovarian tumors, and one had endometrial cancer.
A total of 99.9% of women categorized as being high risk based on the ROCA results did in fact have cancer, meaning that the rate of false-positives "is very, very low," Lu says.
The study also showed that based on ROCA results, no more than three operations were needed to detect one case of invasive ovarian cancer.
"Within the medical community, we feel like it should be no more than 10 operations to detect one case of invasive cancer, so this is within those parameters," Lu says.
There were not enough patients to determine the false-negative rate, Lu says.
The approach missed two borderline cases; however, no invasive ovarian cancers were missed.
"Could these borderline cases become invasive later? It's possible, but biologically, they tend to act differently," Lu says.
Both Lu and ASCO president-elect George W. Sledge Jr., MD, of the Indiana University School of Medicine, say they are cautiously optimistic.
"These early results suggest that looking at an old friend in a new way may be the answer. But I'm skeptical given the false starts," Lu says.
At one cancer meeting last year, "about five groups submitted their best candidates" and none panned out, she says.
Until researchers can show the approach actually saves lives, it will not be ready for prime time, says Sledge, who was not involved with the study.
That is currently being tested in a study of more than 200,000 women in the U.K. Results should be available in four or five years, Lu says.