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June 3, 2015
For almost every cancer type, discovering signs as early as possible significantly improves survival rates. For the most dangerous cases, such as ovarian cancers, this effect is pronounced. According to the Ovarian Cancer National Alliance (OCNA), 92.3 percent of ovarian cancer patients in the localized stage survive five years after their diagnoses. However, only 15 percent of all patients fall into this category. Much more prevalent are the 62 percent of metastasized cancer cases in the distant stage, which exhibits a 27.4-percent survival rate.
Therefore, early screening and detection of ovarian cancer continues to be a hot topic in the fight against the disease. However, there currently is no screening standard as research has not proven any one method to be more effective. There may be a new and more accurate screening method, though, as noted in a new study conducted by researchers from the U.K.'s University College London (UCL) and published in the Journal of Clinical Oncology. By measuring a biomarker protein over time instead of at fixed points, the researchers may have discovered a better way of screening for invasive epithelial ovarian cancer (IEOC).
As researchers begin to understand how the individual genetic makeup of their patients play significant roles in disease development and treatment reactions, catch-all screening methods are being replaced by those that offer more specificity. In the case of ovarian cancer, physicians have traditionally discretely tested for the CA125 protein, which has been linked to IEOC. However, this method functions off of a fixed "cut-off" point for the biomarker that yields accurate results only as high as 48 percent of the time.
Usha Menon, Ph.D., professor of gynecological cancer at UCL and lead author of the study, used data from the U.K. Collaborative Trial of Ovarian Cancer Screening to compile her results of testing CA125 over time. More than 202,000 women age 50 and over participated in the UKCTOCS program, though Menon limited the scope of her study to the 46,237 patients who underwent annual multimodal screenings following their first tests. Blood samples were tested once annually for changes in CA125 levels, and the results were fed into a predictive algorithm developed by the team that took into consideration womens' age as well as known patient levels of CA125 in previously diagnosed IEOC cases.
The new method was able to identify 86 percent of IEOC cases, a significant increase over the cut-off test's 48-percent mark. Though far from perfect, this boost in accuracy may help institute long-term CA125 monitoring as an industry standard for IEOC screening.
"CA125 as a biological marker for ovarian cancer has been called into question," Ian Jacobs, Ph.D., president of the Australia's University of New South Wales and originator of Menon's statistical approach, told Medical Xpress. "Our findings indicate that this can be an accurate and sensitive screening tool, when used in the context of a woman's pattern of CA125 over time. What is normal for one woman may not be so for another. It is the change in levels of this protein that's important. My hope is that when the results of UKCTOCS are available this approach will prove capable of detecting ovarian cancer early enough to save lives."
Another Win for Genetic Research
While the study's findings should represent enough of a success on their own, the way in which the team arrived at their conclusions should also serve as an indicator of personalized medicine's imminent clinical explosion. The UKCTOCS program represented the world's single largest ovarian cancer screening trial, and the fact that such an ambitious project has returned equally impressive results signals hope for the future of other wide-scale genetic research initiatives.