Study suggests that annual CA125 screening may reduce ovarian cancer deaths

December 17, 2015

Initial results from the world's largest ovarian cancer screening trial suggest that tracking levels of a cancer-associated protein over time may help reduce ovarian cancer deaths by as much as 20 percent. Results of the 14-year study, led by investigators at University College London (UCL), are being published online in The Lancet.

The U.K. Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) enrolled more than 200,000 women across the U.K. to investigate whether annual screening with a blood test utilizing the Risk of Ovarian Cancer Algorithm (ROCA), co-developed by Steven Skates, PhD, of the Massachusetts General Hospital (MGH) Biostatistics Unit, can reduce ovarian cancer deaths. ROCA analyzes the results of annual blood tests for CA125, a protein known to be elevated in the blood of women with ovarian cancer.

While monitoring CA125 levels can be useful for predicting a patient's prognosis and tracking response to treatment, CA125 testing has not been recommended for screening women at average risk of ovarian cancer, since previous studies found the risks of such screening far outweighed potential benefits. Instead of a being one-time blood test, ROCA analyzes a woman's CA125 pattern over time to identify any significant increase over her baseline levels.

Beginning in 2001 UKCTOCS enrolled more than 202,000 postmenopausal women, ages 50 to 74, without a strong family history of ovarian cancer. Participants were randomly assigned to one of three groups -- annual multimodal screening with ROCA and transvaginal ultrasound as a second-line test, annual ultrasound screening alone, and a control group that received no screening. When ROCA screening identified a significant CA125 increase, the patient's risk was classified as either elevated, requiring transvaginal ultrasound along with a repeat blood test within the next six weeks, or intermediate, requiring a repeat blood test in three months. Annual screening in the ultrasound-only group resulted in a similar triaging of participants. In both screening groups if abnormal results persisted, participants were referred to a clinician for definitive diagnosis and treatment.

Initial analysis of the study results found that screening was associated with reduced mortality from ovarian cancer -- with a greater reduction in the group receiving multimodal screening -- but the differences were not statistically significant. However, a comparison between the multimodal and control groups that excluded women found to have evidence of ovarian cancer upon entering the study did find that screening was associated with a significant reduction of around 20 percent in the risk of dying from ovarian cancer during the study period. Since the mortality reduction was greatest in the later stages of the trial, the research team believes that the difference will become even larger in subsequent years. They will continue to follow up study participants for an additional three years to confirm the size of the mortality reduction.

Skates developed ROCA in the early 1990s in collaboration with Ian Jacobs, MBBS, FRCOG, who was then at the Royal London Hospital. Now an honorary professor at UCL and vice chancellor at the University of New South Wales in Australia, Jacobs is co-corresponding author of The Lancet paper with Usha Menon, MD, of the UCL Institute for Women's Health, and Skates is one of several co-investigators.
UKCTOCS was funded by grants from the Medical Research Council, Cancer Research U.K., the U.K. Department of Health and The Eve Appeal. Skates' initial work in developing ROCA was supported by the National Cancer Institute. Development rights to ROCA have been licensed to Abcodia, Ltd.

Massachusetts General Hospital (, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $760 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine. In July 2015, MGH returned into the number one spot on the 2015-16 U.S. News & World Report list of 'America's Best Hospitals.'

Massachusetts General Hospital

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to