The results of the UK Familial Ovarian Cancer Screening Study (UK FOCSS), which is led by UCL, show that screening women at high risk of ovarian cancer every four months may reduce the likelihood of them being diagnosed with advanced cancer.
It remains uncertain whether detecting ovarian cancer by screening increases the chances of a woman surviving the disease.
For women at high risk, the current medical advice is to have their ovaries and fallopian tubes removed after having completed their families, but many women delay or decide against having the surgery.
The UK FOCSS results, published in the Journal of Clinical Oncology, indicate that four monthly screening with the Risk of Ovarian Cancer Algorithm (ROCA) may be an option for these women until they decide to undergo surgery.
The algorithm is used to look for rising levels of a blood protein, CA 125, which can be elevated in ovarian cancer.
Over 4,000 women with a 1 in 10 or greater risk of developing ovarian cancer due to family history or a faulty gene, took part in the study after declining surgery. A significant proportion of these cancers occur before the age of 50 but many women are keen to delay surgery until they have completed their families or had a natural menopause.
Over the three years of screening and in the year after their last test, nineteen women were diagnosed with ovarian cancer although none had any symptoms. The screening was estimated to be able to pick up 9 out of every 10 cancers.
A further 18 women were diagnosed with ovarian cancer in the five-year period that followed. Seventeen (94%) of these 18 women had advanced stage cancer (IIIB-IV) compared to seven (37%) of the 19 diagnosed during the screening phase.
The ROCA test is licensed to Abcodia Ltd, a UCL spin-out company. The lead researchers of this study hold shares in and/or consultancy roles with Abcodia.
Professor Ian Jacobs, UK FOCSS Principal Investigator (UNSW Sydney, Australia and UCL EGA Institute for Women's Health), said: "I am delighted that this phase of the 20 year UK FOCSS research effort suggests there is a role for ovarian cancer screening in women at high risk".
Dr Adam Rosenthal, Clinical Lead on the trial (UCL EGA Institute for Women's Health) said: "The screening appears to be very effective at detecting ovarian cancer before it causes symptoms. The proportion of women who had all their tumours removed was very high, which is important in terms of predicting a better outcome."
Professor Usha Menon (UCL EGA Institute for Women's Health) added: "These results suggest that for women at high risk not opting for surgery, four monthly screening maybe a better option than the current NHS practice of symptom awareness and ad hoc annual screening."
Athena Lamnisos, Chief Executive of The Eve Appeal, a gynaecological cancer charity which co-funded the study, said: "Knowing that you are at high risk of developing ovarian cancer is a huge stress for women and their families. This research gives women hope and confidence that there is an evidence-based approach to screening if they decide to delay risk-reducing surgery."
UK FOCSS is a national multicentre study involving 42 NHS Trusts, supported by the NIHR Clinical Research Network. It is led by UCL and funded by Cancer Research UK, the Health Departments of the UK and The Eve Appeal.
Article: Evidence of stage-shift in women diagnosed with ovarian cancer during Phase 2 of the UK Familial Ovarian Cancer Screening Study (UK FOCSS), Journal of Clinical Oncology, published 27 February 2017.