Until now, medical clinicians have lacked a reliable, accurate, and safe way to screen for ovarian cancer, the fifth-leading cause of cancer death in American women. A study released online last week by the journal Cancer seems to be a giant step in the right direction.
Every year, about 22,000 women in the United States learn that they have ovarian cancer. It may be one of more than 30 different types, some of which are benign, others metastatic. Known risks for cancer of the ovaries include family history, patient age, childbearing status, and personal history of other cancers. Oncologists think of this ovarian disease as "a silent killer."
If ovarian cancer is diagnosed early, the five-year survival rate is excellent, greater than 90%. However, since the symptoms are vague, the only way to discover ovarian cancer early has been through pelvic and rectal exams, with confirmation of a biopsy by a pathologist. Historically, only about one-quarter of all patients have their cancers found in time this way. Ovarian cancers detected later are less treatable: patients have only a 50-50 chance of surviving for five years.
The study, performed at the M.D. Anderson Cancer Center in Houston, ran for 11 years. The researchers screened 4,000 post-menopausal women between the ages of 50 and 74 with no personal or family history of ovarian cancer. They measured a blood protein called CA-125, which is shed by tumor cells, and used an ultrasound exam in the following step to take a look at the ovaries of high-risk patients (about 3% of those tested). Average testing time was once a year for four years.
The two-stage screening strategy identified early-stage ovarian cancers with a high positive predictive value. It proved nearly 100% accurate at ruling out false positive results, which have caused some needless surgeries and excessive use of radiation and chemotherapy in the past.
"The results from our study are not practice-changing at this time," said study researcher Dr. Karen Lu, a well-known professor of gynecologic oncology at the University of Texas. The research team feels more data are needed to confirm the finding. "However," Lu continued, "our findings suggest that using a longitudinal (or change-over-time) screening strategy may be beneficial in postmenopausal women with an average risk of developing ovarian cancer."
A much larger study in the United Kingdom (200,000 women, carefully age- and racially balanced), scheduled for completion in two years, may confirm the validity of the work of Dr. Lu and her colleagues. Lu also is an expert on endometrial cancer and Lynch syndrome.
Her concise (if unscientific) conclusion: the just-published study is "a ray of excitement" on a previously thorny area of cancer diagnosis.
Based in Chicago, Sandy Dechert has been covering science and health for Examiner.com since the webzine's official startup. In the health area, she began investigating MERS before the disease was officially named and H7N9 human influenza on the day the Chinese announced it. She has also followed American seasonal influenza, the cancer diagnoses of public figures like Robin Roberts and Valerie Harper, and the creation, enactment, and progress of the Affordable Care Act (Obamacare). Sandy's science articles appear frequently in Examiner's women's and sexual health columns and under environment and energy, as well as elsewhere in the digital world.
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