The majority of women who undergo surgery for suspected ovarian cancer do not have cancer. A novel blood test developed by researchers at Uppsala University and the Sahlgrenska Academy, University of Gothenburg, in Sweden, now offers the possibility of more precise diagnostics without the need for surgery. This could lead to a reduction in unnecessary surgery and to earlier detection and treatment for affected women. The study was recently published in Communications Biology.
Ovarian cancer is often discovered at a late stage and has a high mortality rate. Out of 10 patients, only 3-4 survive 5 years after treatment, and there has been no test specific enough to justify screening. Women with accidental findings of an ovarian cyst or with symptoms instead undergo ultrasound and if abnormalities are seen, surgery is the only way to make sure all cancers are detected. This means that many women are operated on without having cancer, resulting in unnecessary surgery and increased risks for women.
We need to develop more accurate pre-surgery diagnostics. To detect one cancer, we operate on up to five women - yet this is currently the best option when abnormalities are detected by ultrasound and cancer is suspected. There is a great need for a simple blood test that could identify women who do not need surgery."
Karin Sundfeldt, Professor and Senior Consultant at the Department of Obstetrics and Gynecology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg
In the published study, the researchers have developed a biomarker test based on analysis of 11 proteins. The test, which is performed on a blood sample, is used where ultrasound has indicated abnormalities to identify women without cancer. For cases in which physicians chose to operate, the cancer rate could increase from one in five to one in three. This would greatly reduce unnecessary surgery and the risk of complications related to surgery.
The biomarker profile can also detect borderline cases and early stages of the disease.
"Our results are promising enough to consider screening for early discovery of ovarian cancer. In Sweden, we have long experience of screening for cervical cancer. I see great prospects of developing a strategy for screening for ovarian cancer as well, which could save lives and minimize the need for surgery to rule out cancer," says Ulf Gyllensten, Professor of Medical Molecular Genetics at the Department of Immunology, Genetics and Pathology at Uppsala University.
The paper, published in the open access journal Communications Biology (Springer Nature Publishing AG), presents a new test that has been developed in collaboration with Uppsala-based biotech company Olink Proteomics AB.
"We are now continuing to evaluate the test and are performing a large-scale study of samples collected at all hospitals from the western region and Halland healthcare system," says Gyllensten.
Enroth, S. et al. (2019) High throughput proteomics identifies a high-accuracy 11 plasma protein biomarker signature for ovarian cancer. Communications Biology. doi.org/10.1038/s42003-019-0464-9