Ovarian cancer deaths could drop by 20% with annual blood test

Ovarian cancer deaths could be slashed by 20% with an annual blood test, experts say.

In the biggest ever study into the disease , scientists found that carrying out screening in women who are at risk can reduce the numbers who die from it.

The 14-year trial suggested a yearly blood test for levels of a particular protein could prevent 15 deaths for every 10,000 women screened.

Health experts hailed the work as a “landmark step” in tackling ovarian cancer but warned more research was needed before the screening process should be widely introduced.

The study - the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) - was carried out by scientists in the UK and Australia with the backing of the Department of Health, the UK Medical Research Council and cancer charities.

Ovarian cancer kills around 4,000 women each year in the UK and is usually diagnosed at an advanced stage, with 60% of patients dying within five years of diagnosis.

UKCTOCS tested more than 200,000 post-menopausal women for 14 years at 13 centres across the UK.

The study compared those who received no screening, those who were given a yearly ultrasound and those who received an annual blood test for levels of the protein CA125, with an ultrasound as a second-line test.

During the period of the study 1,282 women were diagnosed with ovarian cancer.

Results suggested that for women who received the annual blood test, the current reduction in death rates is estimated at 15%.

This was made up of an 8% reduction for the first seven years, followed by a 23% relative mortality reduction between years seven and 14.

Analysis that excluded cases of the cancer already being prevalent estimated that a long-term effect of such a screening was approximately a 28% fall in death rates after year seven.

The study found that around 15 deaths could be prevented by the blood test for every 10,000 women screened. However, for every woman with a positive screening who subsequently received surgery and was found to have ovarian cancer, two did not.

The report said: “After excluding women who, when they joined the trial, had undiagnosed ovarian cancer, there was a significant reduction in deaths with an average mortality reduction of 20% and in years seven to 14 of 28%.”

Study lead member Prof Ian Jacobs, of the Institute of Women’s Health at University College London, added: “These results from UKCTOCS provide estimates of the mortality reduction attributable to ovarian cancer screening which range from 15% to 28%.

“Further follow-up in UKCTOCS will provide greater confidence about the precise reduction in mortality which is achievable. It is possible that the mortality reduction after follow-up for an additional two to three years will be greater or less than these initial estimates.”

The report authors suggested that careful screening of this type could detect ovarian cancer early enough to help reduce death rates, but warned that more work needs to be done to determine the ultimate fall deaths and whether widespread screening can be cost-effective.

They said: “This opens up a new era in ovarian cancer research and care. Whether or not population screening is justified will depend upon a range of factors including further follow-up to determine the full extent of the mortality reduction and health economic analyses.

“Meanwhile efforts can be made to refine ovarian cancer screening, develop tests with greater sensitivity and more lead time and improve ways to risk stratify the population.”

Dr Adam Shaw, clinical lead for cancer genetics at London’s Guy’s and St Thomas’ Hospital, said the results were “encouraging”.

 “Nonetheless, this study is a landmark step in devising effective screening for ovarian cancer, which is often portrayed as the silent killer.”

Prof Christina Fotopoulou, from the Ovarian Cancer Action Research Centre, said: “We’ve always been one step behind the disease but a screening method would allow us to catch it at a stage that makes treatment more effective.

“While we’re not there yet, and will need to wait for further study and definitive results, UKCTOCS shows that research in the field is gaining pace.

Dr Clare Mckenzie, vice president for the Royal College of Obstetricians and Gynaecologists, added: “This study is important in that the early detection of ovarian cancer, and hence early treatment, has the potential to save lives.

“However, longer follow-up is needed to determine how effective the test is. Women who are worried about ovarian cancer should talk to their doctor who can explain their risk of cancer and available tests.”