Screening unhelpful in lowering deaths from ovarian cancer

By Dr. Ananya Mandal, MDJun 5 2011

New research shows that women regularly screened for ovarian cancer are just as likely to die from the disease. This comes as no surprise as there are still no adequate detection methods, says Ovarian Cancer Australia. Of the 1,200 Australian women diagnosed with ovarian cancer each year, 800 die, often because it is diagnosed too late to be treated.

According to Ovarian Cancer Australia chair Paula Benson available screening tests were inadequate in detecting the disease, making it important for women to be aware of symptoms. She explained, “If women experience persistent abdominal pain, abdominal bloating, feeling full quickly after eating, or an urgency to urinate, they should visit their doctor.”

US scientists reported yesterday that ovarian cancer screening might not reduce risk of dying from the disease. A trial of nearly 80,000 women, aged 55 to 74, found those to have annual blood tests and ultrasounds did not have a reduced risk of death from ovarian cancer compared with women who were not screened. However, as a result of being screened some women underwent unnecessary surgery after false positives came up in either their tests.

Cancer Research UK said it was seeking new methods to detect the cancer. While ovarian cancer is not the most common in the UK, it causes more than 4,000 deaths a year. Two types of test are at the centre of hopes for a successful screening programme - a blood test looking for a high levels of a chemical associated with the cancer, and an ultrasound test which looks directly for abnormalities.

Dr James Brenton, an ovarian cancer specialist at Cancer Research UK, said that the charity was funding research into different methods of spotting tumors in their early stages. He said, “This important research suggests that having a yearly ultrasound test along with a blood test, which provides a snapshot of the levels of protein associated with ovarian cancer - the serum CA125 test - is not going to cure more women. We are testing whether smaller rises in CA125 over time can be a better predictor, and working with international groups to identify common genes that might slightly increase the risk.”

According to lead researcher Dr Saundra Buys, of Utah Health Sciences Centre University annual screening for ovarian cancer did not cut death rates in women at average risk “but does increase invasive medical procedures and associated harms”. Similar rates of cancer and deaths were seen across both groups - 212 ovarian cancer cases and 118 deaths from it in the screened group over 13 years of follow-up. The unscreened group saw 176 cases of ovarian cancer and 100 deaths, but the difference in survival rates “was not statistically significant,” Dr Buys said. However, 3285 women received false-positive results, and 1080 underwent surgery to have one or both ovaries removed. Fifteen per cent of these women experienced “major complications”, Dr Buys said.

Almost 40,000 US women were checked annually over a 10-year period, the Journal of the American Medical Association reported. The research is published in the Journal of the American Medical Association.