New screening method may identify more ovarian cancers
By Andrew M. Seaman (Reuters Health) - A personalized method for interpreting blood tests identifies more ovarian cancer cases than a generalized approach, a new study suggests. Using an algorithm to analyze changes in the level of a specific protein in blood was better at predicting ovarian cancer, compared to waiting until the protein level reached a general "cut-off" point, researchers found. While the results are promising, the study's lead author said it's too soon to use the new screening method in general practice. "It looks like we picked up cancers in more people earlier," said Dr. Usha Menon of University College London. "Now the next question is, did we save these women’s lives by picking them up earlier?" In 2011, about 20,600 U.S. women were diagnosed with ovarian cancer and about 14,300 died of the disease, according to the Centers for Disease Control and Prevention. The U.S. Preventive Services Task Force (USPSTF), a government-backed panel of prevention and medical experts, recommends against screening for ovarian cancer in women, because routine screening has "no proven benefit and may lead to important harms." Presently, using either a blood test to check for high levels of the CA 125 protein or an ultrasound to look for abnormalities may lead to unnecessary surgery to confirm a diagnosis, the USPSTF says. High levels of CA-125 do not always mean a woman has ovarian cancer, the group says. Instead of using a general cut-off point for high CA-125 levels, the new study, scheduled for publication in the Journal of Clinical Oncology, uses an algorithm to analyze several CA-125 readings to determine if there is an especially unusual increase in protein levels. The study followed more than 46,000 women who were at least 50 years old and who had yearly CA-125 measurements. Based on the algorithm, the women were separated into normal, intermediate and elevated risk categories. Normal-risk women continued with annual CA-125 blood tests. Intermediate-risk women received a repeat CA-125 screening, and elevated-risk women received a repeat screening and a transvaginal ultrasound exam. About 86 percent of ovarian cancer cases were identified using the algorithm. Using traditional "cut-off" points would have found only 41 to 48 percent of the cancers, researchers said. "This is an encouraging step toward what everyone hopes will be a reduction in mortality," said coauthor Steven Skates. Until the researchers report on the number of deaths following the new screenings, there should be no change in what doctors do at this point, said Skates, who is a researcher and expert on biostatistics at Massachusetts General Hospital and Harvard Medical School in Boston. "It might be that while we’re catching cancers earlier in time, we’re not catching them sufficiently early to have a reduction in mortality," he said. Menon also told Reuters Health that data on the cost of the screening will be available later this year, after they've analyzed the number of deaths after screening. "This is exciting in the sense that we made progress from what has gone on in the past, but we do need to see what happens in the fall or early winter to see if it’s good enough," she said. SOURCE: http://bit.ly/TwbDyp Journal of Clinical Oncology 2015.
