May 18, 2021 -- Results from a huge British trial that involved more than 200,000 women show that annual screening for ovarian cancer did not reduce the death toll from this aggressive cancer.
"We are disappointed, as this is not the outcome we and everyone involved in the trial had hoped and worked for over so many years," said Usha Menon, MD, of the Institute of Clinical Trials and Methodology in London, and the study’s lead investigator.
The trial is the first “to show that screening can definitely detect ovarian cancer earlier. However, this very large, rigorous trial shows clearly that screening using either of the approaches we tested did not save lives," she said in a statement.
"We therefore cannot recommend ovarian cancer screening for the general population using these methods," she added.
Echoing these sentiments, coinvestigator Ian Jacobs, MD, from the University of New South Wales in Australia, acknowledged that although one screening method did detect ovarian cancer at an earlier stage of disease, "sadly, that did not save lives.”
"This is deeply disappointing and frustrating given the hope of all involved that we would save the lives of thousands of women who are affected by ovarian cancer each year," he added in a statement.
The study was published online May 12 in The Lancet.
At a press briefing, Menon emphasized that ovarian cancer is an aggressive disease, with a 10-year survival of 35%. It is difficult to diagnose, and more than half the cases are diagnosed when the disease is in late stages.
Because screening cannot be recommended at this time, she urged that women and doctors be alert to, and not ignore, symptoms that may suggest ovarian cancer.
For women, it is “important that if you notice unusual or persistent changes to talk to your doctor. Symptoms of ovarian cancer can be quite vague and similar to symptoms caused by less serious conditions, which can make spotting the disease tricky,” added Michelle Mitchell, chief executive at Cancer Research UK, which partly funded the trial.
“Whether it’s needing to go to the toilet more often, pain, bloating, or something else, raise it with your doctor – in most cases it won’t be cancer but it’s best to get it checked out,” she said.
Speculating as to why the finding of earlier-stage disease did not translate into a reduction in deaths overall in this trial, Menon emphasized again that ovarian cancer is aggressive and that perhaps the treatments that were available at the time (10 years ago) were not able to stop its progression.
Since this trial ended 10 years ago, there have been significant improvements in the treatment of advanced ovarian cancer, Mahesh Parmar, PhD, of the Institute of Clinical Trials and Methodology, said.
"Our trial showed that screening was not effective in women who do not have any symptoms of ovarian cancer," Parmar said.
However, he added that in "women who do have symptoms, early diagnosis, combined with this better treatment, can still make a difference to quality of life and, potentially, improve outcomes," Parmar said in a statement.