Approximately 15 deaths could be prevented for every 10,000 women who attend screening
New results from the world’s biggest ovarian cancer screening trial, involving The University of Manchester suggest that screening based on an annual blood test may help reduce the number of women dying from the disease by around 20%.
The research, published today (Thursday) in the Lancet, also cautions that longer follow up is needed to establish more certain estimates of how many deaths from ovarian cancer could be prevented by screening. Estimates from the results so far are promising, but the exact figures remain uncertain.
The UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is an international ovarian cancer screening trial, led by UCL and funded by the Medical Research Council, Cancer Research UK, Department of Health and The Eve Appeal.
The Manchester lead for UKCTOCS and co-author of the publication was Dr Mourad W Seif, Consultant Gynaecologist at Saint Mary’s Hospital and Honorary Senior Lecture at The University of Manchester. Over 16,500 women from Greater Manchester, representing the largest group in the North West, attended regular appointments and annual screenings at the NIHR / Wellcome Trust Manchester Clinical Research Facility, a dedicated research facility at Central Manchester University Hospitals NHS Foundation Trust.
Overall, more than 200,000 post-menopausal women with no symptoms (asymptomatic) aged 50 to 74 took part in the study from across the UK. Ovarian cancer was diagnosed in 1,282 women during the 14-year study of whom 649 had died of the disease by the trial end in December 2014.
The study showed a delayed effect in mortality rates between the screening and control arms, which became significant after the first seven years of the trial. The research team are now following up the study for three more years to establish the full impact of an ovarian cancer screening programme.
The early results suggested that approximately 15 ovarian cancer deaths could be prevented for every 10,000 women who attend a screening programme that involves annual blood tests for between seven to 11 years.
The trial also confirmed previous findings that on average, for every three women who had surgery due to an abnormal screen result, one woman had ovarian cancer while two women did not. For those who had surgery, only around three per cent had major complications, which is the standard complication rate for this type of surgery in the NHS.
The screening blood test, called ROCA uses a statistical calculation to interpret changing levels over time of a blood protein called CA125, which is linked to ovarian cancer. This gives a more accurate calculation of a woman’s individual risk of having ovarian cancer, compared with an alternative method which uses a one-off blood test measuring a fixed ‘cut-off’ point for CA125. The ROCA is licensed to Abcodia Ltd, a UCL spin out company. A recent publication from the same group showed that screening based on the ROCA test will double the chance of detecting ovarian cancer in post menopausal asymptomatic women, when compared with the cut off point.
We hope this discovery will lead to earlier diagnosis, before symptoms occur, and a more effective treatment for women diagnosed with the disease.
Dr Mourad W Seif
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Study Lead Investigator Professor Ian Jacobs, President and Vice-Chancellor of UNSW Australia and Honorary Professor at UCL, who co-invented the ROCA in 1996 and is also a non-executive director of Abcodia Ltd. said: “I am delighted that the UKCTOCS results suggest that early detection by screening can save lives. Longer follow up is needed but this brings hope in the fight against a disease for which the outlook for women is poor and has not improved much during the last three decades.”
Dr Seif said: “The study data indicates for the first time that based on this technique, screening may reduce death from ovarian cancer. Around 3,500 women in England die from ovarian cancer each year and ovarian cancer commonly presents in advance stages.
“We hope this discovery will lead to earlier diagnosis, before symptoms occur, and a more effective treatment for women diagnosed with the disease. I would like to thank all the women who played an important role in this study.”
Barbara Slee, aged 72 from Flixton, was one of the 16,500 women who took part in the UKCTOCS study in Manchester. “It was about 11 years ago when I first signed up to the study and it was following one of my regular screening appointments in 2011 that I was diagnosed with ovarian cancer.
“Luckily for me it was caught in the early stages and I was able to have a surgical procedure. I did not have any symptoms at the time of diagnosis and if I had not been involved in the study, it may have not been picked up on. As a mother of two daughters, I can’t explain how important research like this is to improve diagnosis of ovarian cancer and to help others.”
Dr Fiona Reddington, Cancer Research UK’s head of population research, said: “This trial has been incredibly useful in improving our understanding of ovarian cancer. Detecting it early is vital to make sure that patients have the best treatment options and that more women can survive the disease. It’s uncertain whether or not screening can reduce ovarian cancer deaths overall. While this is an important step in ovarian cancer research, we would not recommend a national screening programme at this point.”
Jacobs, Menon et al., ‘Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial’ was published in The Lancet.
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Luckily for me it was caught in the early stages and I was able to have a surgical procedure. I did not have any symptoms at the time of diagnosis and if I had not been involved in the study, it may have not been picked up on. As a mother of two daughters, I can’t explain how important research like this is to improve diagnosis of ovarian cancer and to help others.
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