Ovarian cancer screening
This page is about screening for ovarian cancer. You can find the following information
Ovarian cancer screening
Before screening for any type of cancer can be carried out, doctors must have an accurate test to use. The test must be reliable in picking up cancers that are there. And it must not give false positive results in people who do not have cancer.
At the moment, there is no screening test that is accurate and reliable enough to detect ovarian cancer in the general population. But there are clinical trials looking into screening. A large UK trial is expected to publish their final results in 2015.
Screening women at higher risk
Higher than average risk means having 2 or more relatives on the same side of the family diagnosed with ovarian cancer or breast cancer at a young age, particularly if they were diagnosed before they were 50.
If you think you are at higher than average risk for ovarian cancer, you should talk to your GP. They can get in touch with your local genetics service (family cancer clinic). Staff at the centre will ask questions about your family history and offer you counselling about your options, including the possible risks and benefits of screening. But you must bear in mind that the screening tests have not been fully tested yet and there is no guarantee that they will pick up every case of early ovarian cancer.
You can view and print the quick guides for all the pages in the about ovarian cancer section.
Screening tests particular groups of people to find cancer early, when the chance of cure is highest. Before screening for any type of cancer can be carried out, doctors must have an accurate test to use. The test must be reliable in picking up cancers that are there. And it must not give false positive results in people who do not have cancer.
At the moment, there is no screening test reliable enough to use to look for ovarian cancer in the general population. But clinical trials are looking into screening tests for ovarian cancer that may be helpful for
Until these trials publish their final results, we won't know whether the screening tests that are used work or not.
Two main tests have been tested in screening trials for ovarian cancer
CA125 is known as a tumour marker for ovarian cancer. A tumour marker is a chemical given off by cancer cells that circulates in the bloodstream. Women with ovarian cancer tend to have higher levels of CA125 in their blood than women who do not have ovarian cancer. But there are some problems with this test that make it unsuitable for use as a screening test on its own
- Only about 85 out of every 100 women with ovarian cancer (85%) have raised CA125
- Only 50 out of every 100 women with early stage ovarian cancer (50%) have raised CA125
- Women with other conditions can also have raised CA125
So you can see that if this test was used on its own, it would miss some cases of ovarian cancer. It would also pick out other women who did not have ovarian cancer. They would then need to have further tests, which could cause them anxiety and harm. We need to have another test that can reliably show who has ovarian cancer and who hasn't.
Researchers are looking for other possible tumour markers for cancer of the ovary. Doctors hope that by combining blood tests for markers they may be able to pick up more cancers and rule out people who don't have cancer more easily.
This is an ultrasound examination done by putting the ultrasound probe into the vagina. It gives a better picture of the ovaries than an ultrasound over the abdomen. Even so, it can still be difficult to tell whether there is a cancer on the ovary or just a harmless cyst.
A trial called UKCTOCS is looking at ovarian cancer screening in the general population between the ages of 50 to 74. It finished recruiting women in September 2005. The women who took part were selected at random from GP lists and then invited to join. This was so that the researchers got the most reliable results possible.
Over 200,000 women took part in this trial. Of those
- One quarter had a blood test for the CA 125 tumour marker
- One quarter had a transvaginal ultrasound scan
- Half had no screening test - doctors call this the control group
The first phase of the results were published in March 2009. The screening tests found 58 cancers, but missed the cancer in another 12 women. About half the cancers they found were at an early stage. Researchers are still following up the women in this study and are expected to present their results in 2015.
You may be able to have screening tests if you are thought to be at higher than average risk for ovarian cancer. This means having 2 or more relatives on the same side of the family diagnosed with ovarian cancer or breast cancer at a young age. If your relatives were diagnosed before they were 50 years old, you may be able to have screening. But it is important to remember that these screening tests have not been fully tested yet. There is no guarantee that the tests will pick up every early ovarian cancer.
If you think you are at high risk of ovarian cancer, go to your GP. Your doctor can get in touch with your local genetics service (also called the family cancer clinic). They can assess you and you may be put on the UK Familial Ovarian Cancer Registry. You will have counselling about your options, including the possible risks and benefits of screening.
If you are found to be at higher risk, you can be screened
- From 35 years old onwards or
- From 5 years before the age at which your youngest relative was diagnosed
The UK Familial Ovarian Cancer Screening Study (UK FOCSS) is looking at screening women who are at a high risk of developing ovarian cancer because they have a family history of cancer of the ovary or breast, or they have family members with a known genetic fault (such as BRCA 1 or BRCA 2). It finished recruiting women in 2010.
Results from the first part of this study showed that screening once a year was not so good at picking up early stage ovarian cancer in women at increased risk. The researchers thought it may be better to have screening more often. So from 2007, women taking part in the study had screening every 4 months. The researchers are now following up the women in the second part of this study. They plan to publish these results in the future.
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