Ovarian cancer screening is put to the test, with encouraging results

CA-125, the protein long recognized for its use in predicting ovarian cancer response to treatment and recurrence, now is showing promise as a screening tool for the disease in its early stages.

“Finding a screening mechanism would be the Holy Grail in the fight against ovarian cancer,” says Karen Lu, M.D., chair of Gynecologic Oncology and Reproductive Medicine at MD Anderson. “When caught early, it’s not just treatable, it’s curable.”

Led by MD Anderson, an 11-year study enrolled 4,051 women across the country. All were healthy, post-menopausal and had no family history of ovarian or breast cancers.

The women received baseline CA-125 blood tests. Using a mathematical model based on age and CA-125 score, study participants were placed into one of three risk groups: low, intermediate or high. Medical follow-up corresponded accordingly.

Based on their CA-125 change over time, cumulatively, 117 study participants were determined to be high risk. They received a trans-vaginal ultrasound and were referred to a gynecologic oncologist. Of those, 10 women underwent surgery. Four had early-stage, invasive, high-grade epithelial tumors, which were caught at the earliest, most curable stage. Two women had borderline disease, one had endometrial cancer and three had benign ovarian tumors.

While encouraging, the findings are neither definitive nor practice-changing, stresses Lu. A large, randomized prospective screening trial of more than 200,000 women is ongoing in the United Kingdom. Results should be known by 2015.

“As a clinician treating women with this disease for more than a decade, I’m an admitted skeptic of ovarian cancer screening,” Lu says. “With these findings, I’m cautiously optimistic that in the not-too-distant future, we may offer a screening method that detects the disease in its earliest stages and makes a difference in the lives of women in need.”