Ovarian Cancer Screening Not Catching Early Disease

April 02, 2009

The new study looked at a screening regimen that combines ultrasound and a blood test for CA-125, a marker for women's cancer.

Results showed the combo screening caught 70 percent of the ovarian cancers in their late stages, when effective treatment options are limited.

Knowing this screening limitation means the search has intensified for a better way to detect ovarian cancer, often called the "silent killer," said Edward Partridge, M.D., director of the UAB Comprehensive Cancer Center and the lead study author.

"We still have some comparison data to review, but right now it looks like the positive predictive value of these tests is pretty low," Partridge said.

The study puts the positivity value for both tests at around 1.6 percent per 100 positive screening results, a remarkably low positivity rate that led to many false positives, he said. False positives are erroneous signals of cancer where there is none.

The UAB results are published April 1 in the journal Obstetrics & Genecology.

Searching For Stronger Clues

One alarming trend noted in the study is how often transvaginal ultrasound led to a high rate of unnecessary removal of the ovaries, which means no cancer was detected in these organs post-surgery.

"This data suggests that we need a better screening tool. We need a test that is more sensitive and more specific so we find the cancer earlier and we catch the biological markers that give us stronger clues," Partridge said.

The study was part of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO trial) and included more than 72,000 women aged 55 to 74.

The PLCO results coincide with a British study published March 10 online in The Lancet Oncology that found combo screening for ovarian cancer was extremely successful in finding early stage cancers. But that still doesn't mean the screens led to a reduction in the ovarian cancer death rate, reported the British study authors from the University College London.

Ovarian cancer ranks as the fifth leading cause of female cancer death, and it is diagnosed primarily in women aged 55 and older. Early stages of the cancer cause somewhat vague symptoms and many malignancies go undetected until other organs and tissues are involved.

The UAB study was a partnership between PLCO investigators at the Huntsman Cancer Institute in Salt Lake City; the University of Colorado Cancer Center in Denver; the Washington University School of Medicine in St. Louis; Georgetown University in Washington, D.C.; University of Pittsburgh Medical Center; the Henry Ford Health System in Detroit; the Pacific Health Research Institute in Honolulu; the University of Minnesota in Minneapolis and the National Cancer Institute in Bethesda, Maryland. Funding was from the National Institutes of Health.

UAB's Comprehensive Cancer Center is a national leader in women's cancer through partnering with its Division of Gynecologic Oncology. The university's Lynn Cohen Clinic offers a team approach to cancer risk assessment, treatment and survival care.

University of Alabama at Birmingham

---

---

	Memoir of a Debulked Woman: Enduring Ovarian Cancer by Susan Gubar (Author) In this moving memoir, a renowned feminist scholar explores the physical and psychological ordeal of living with ovarian cancer.Diagnosed with ovarian cancer in 2008, Susan Gubar underwent radical debulking surgery, an attempt to excise the cancer by removing part or all of many organs in the lower abdomen. Her memoir mines the deepest levels of anguish and devotion as she struggles to come to terms with her body’s betrayal and the frightful protocols of contemporary medicine. She finds solace in the abiding love of her husband, children, and friends while she searches for understanding in works of literature, visual art, and the testimonies of others who suffer with various forms of cancer.Ovarian cancer remains an incurable disease for most of those diagnosed, even those lucky enough...
	A Guide to Survivorship for Women with Ovarian Cancer (A Johns Hopkins Press Health Book) by F. J. Montz (Author), Robert E. Bristow (Author), Paula J. Anastasia (Assistant) This comprehensive guide to ovarian cancer offers a wealth of information to ease the physical, emotional, and psychic suffering of women with the disease. The authors—two Johns Hopkins gynecologic oncologists and a gynecologic-oncology clinical nurse—put particular emphasis on the concept of "survivorship," or living life well in the face of daunting uncertainties. They stress the importance of self-determination: the right of each patient to be informed, involved, and in control of her care. Up-to-date information on diagnosis and treatment, including surgery, chemotherapy, radiation, pain management, and alternative therapies, forms the core of the book. But the authors' immense clinical experience also means they understand what women worry about and care about, and they address...
	Johns Hopkins Patients' Guide to Ovarian Cancer (Johns Hopkins Patients' Guides) by Robert Bristow (Author) The Johns Hopkins Patients Guide to Ovarian Cancer is a concise, easy-to-follow how to guide that puts you on a path to wellness by explaining ovarian cancer treatments from start to finish. It guides you through the overwhelming maze of treatment decisions, simplifies the complicated schedule that lies ahead, and provides valuable tools to help you to put together your plan of care. Empower yourself with accurate, understandable information that will give you the ability to confidently participate in the decision making about your care and treatment.
	Beating Ovarian Cancer: How To Overcome The Odds And Reclaim Your Life by Chris Bledy (Author) A diagnosis of Ovarian Cancer does not have to be a death sentence. Recent advances in medicine have made this once incurable disease treatable and manageable. You can beat advanced and even recurring, ovarian cancer. Simple but significant lifestyle changes can produce big results when it comes to healing.
	100 Questions & Answers About Ovarian Cancer, Second Edition by Don S. Dizon (Author), Nadeem R. Abu-Rustum (Author) Whether You’Re A Newly Diagnosed Ovarian Cancer Patient, A Survivor, Or A Friend Or Relative Of Either, This Book Offers Help. Completely Updated, The New Second Edition Of 100 Questions & Answers About Ovarian Cancer Gives You Authoritative, Practical Answers To Your Questions About Treatment Options, Post-Treatment Quality Of Life, Sources Of Support, And Much More. Written By A Gynecologic Oncologist And A Gynecologic Surgeon, With Actual Patient Commentary, This Book Is An Invaluable Resource For Anyone Coping With The Physical And Emotional Turmoil Of This Frightening Disease.
	Ovarian Cancer: Your Guide to Taking Control (Patient Centered Guides) by Kristine Conner (Author), Lauren Langford (Author) This unique guide for ovarian cancer gives women crucial medical information to improve the chance for lengthy remission and cure, as well as emotional support for the journey. Although many ovarian cancers are discovered after they have spread, having information about surgery and best practices can be life-saving. For example, choosing a surgeon from the new specialty of gynecologic oncology for staging and de-bulking surgeries strongly impacts survival. Women need to at least consider newer chemotherapy and biological treatments in research trials. Women also want to hear the stories of others who live with the ambiguity of remission. Ovarian Cancer includes: Ten things to know at the time of diagnosis, for optimal outcome How choosing a gynecologic oncology surgeon impacts survival...
	A Feather in My Wig: Ovarian Cancer Cured, Twelve ( Seventeen) Years and Going Strong! by Barbara R. Van Billiard (Author), Theodore C. Barton (Contributor) With sensitivity and with humor, Barbara Van Billiard sets down the facts of her struggle and outlines the steps she took to deal with surgeries and chemotherapy. Her use of, and explanation, of various mind-body techniques, such as imagery and meditation, are a thought provoking approach that any cancer patient could use to help with life threatening illness.
	No Time to Die:: Living with Ovarian Cancer by Liz Tilberis (Author) In 1993 Liz Tilberis seemed to have it all. She was a working mother with a family who adored her. As editor-in-chief of Harper's Bazzar, she lived at the center of the glamorous world of international fashion and was widely recognized as one of the most powerful people in the industry. And in 1993, Liz Tilberis was diagnosed with Stage III ovarian cancer.Suddenly she was faced with the challenge of a lifetime, joining the ranks of the 175,000 women in America with Ovarian cancer. She underwent major surgery, grueling chemothereapy, and, eventually, when the cancer recurred, a life-threatening bone marrow transplant. Through it all she refused to let the disease get the better of her, continuing to participate fully in her life as wife, mother, and career woman. And she eduacted herself...
	Ovarian Cancer Journeys: Survivors Share Their Stories To Help Others by Ayala Miron (Author) "All of the research has reinforced that ovarian cancer is not a silent disease as was once thought and as is shown quite eloquently in this collection of stories.... The value of this collection of stories is that it helps raise awareness about symptoms, need for patient persistence, and the importance of being treated by a gynecologic oncologist." Barbara A. Goff, MD Professor and Co-Director, Division of Gynecologic Oncology University of Washington School of Medicine Women of ages 17 to 78 join to tell their true stories. Find out about the lessons they have learned along their ovarian cancer journeys; from symptoms to diagnosis, trough treatments, and survival. Ovarian cancer facts: Occurs in 1 out of 57 women 89% have symptoms at the early stages of the...
	Gilda's Disease: Sharing Personal Experiences and a Medical Perspective on Ovarian Cancer by M.D. M. Steven Piver (Author), Gene Wilder (Collaborator) The first book on ovarian cancer for the general reader, this is a comprehensive, compassionate look at a disease millions of people first became aware of with the tragic death of comedienne Gilda Radner in 1989. Dr. Piver, a leading cancer surgeon, discusses the causes of ovarian cancer, preventative measures, classic signs and symptoms, diagnostic tests and genetic screening, the different types of ovarian cancer, the four stages in the disease's progression, and the most effective treatments. Gene Wilder's intimate commentary, letters from Gilda's fans, and excerpts from her book, It's Always Something, bring a personal perspective to Dr. Piver's expert medical advice. This remarkable collaboration will help women feel more hopeful, and less scared and alone, when faced...