CBC news report: Tests may detect ovarian cancer sooner: study

Comment: spniauskas

Posted 2009/03/11
at 3:42 PM ET

Dr Jacobs published a randomised trial in the Lancet in 1999. This study was again specific to screening/early detection of ovarian cancer. In this study, now a decade old, 22,000 women enrolled. The abstract can be viewed at: http://www.ncbi.nlm.nih.gov/pubmed/10217079?holding=ukpmc

or: http://tinyurl.com/alo2st

Similar results were found in that of the 22,000 in the prior study (1998), 468 women had an elevated CA125 with 6 actual detections of malignancy. The current study indicates that of the 50,000 women screened with a CA125, 38 were found to have a malignancy. Without having read the full paper recently published, but relying on the abstracts, it would seem the 1999 and 2009 results do not differ in any appreciable way. The only question I might have would be in any technological advances in the ultrasounds which were used. There are several issues here which will and have always impacted decision-making specific to ovarian cancer. One is based on the fact that a public screening (meaning all women) of the CA125 will not be adopted, such as the PSA, because the cost are too high and the results are two low. Even the PSA test for public screening has been debated widely over the years. Assuming patients symptoms are acknowledged and there is a suspicion of ovarian cancer then nothing really has changed as it is the responsibility of the health care professional to order the appropriate tests. This brings us back to the same issues we have faced in ovarian cancer (forever) and that is recognizing the symptoms, however, complicated this may be. Lastly, Australia/UK today are using a test called the HE4 which, when added to the CA125, apparently improves detection of ovarian cancer. It would be most interesting for someone to compare the 2 Jacob trials.