First evidence to suggest screening for ovarian cancer may save lives

Posted on in Research, The trust

New results from the world’s biggest ovarian cancer screening trial, which involved 10,000 women from the Teesside area, 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.Derek-Cruickshank

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 James Cook University Hospital in Middlesbrough was one of 13 centres involved, with 10,000 local women aged between 50 and 74 contributing to this ‘landmark’ trial.

Derek Cruickshank, a consultant in gynaecological oncology, said: “This is the second largest randomised trial ever globally and it’s great that the trust has been involved in this important study. Thousands of women on Teesside felt this was an important enough health issue to take part and the trial has been incredibly useful in improving our understanding of ovarian cancer as well as raising awareness.

“It was also a significant undertaking for our staff to run the programme and I’d like to thank them for their involvement.”

During the 14-year study of more than 200,000 post-menopausal women, ovarian cancer was diagnosed in 1,282 women, of whom 649 had died of the disease by the trial end in December 2014.

The study showed a delayed effect on mortality 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 ovarian cancer screening.

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 as a result of an abnormal screen, one woman had ovarian cancer while two women did not. For those who had surgery, 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.

Professor Usha Menon, UCL Women’s Health, who co-led the trial and receives research funding from Abcodia, said: “UKCTOCS has been an immense research effort spanning 14 years, over 200,000 women and 700,000 annual screens. Finally we have data which suggests that screening may prevent ovarian cancer deaths. This is welcome news and provides fresh impetus for renewed efforts in this area.”

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.”

Athena Lamnisos, CEO of The Eve Appeal said: “These results don’t necessarily signal the introduction of a national screening programme, but they are an exciting step forward for early detection of ovarian cancer. Medical research takes time to shift from the lab bench to the hospital bedside; today, the UKCTOCS results move early detection one step closer.”