New Ovarian Cancer Screening Approach shows promise….
A new ovarian cancer screening approach appears to be effective for women at average risk of developing the disease. The Risk of Ovarian Cancer Algorithm (ROCA), which is based on patient age and trends in CA-125 blood testing, demonstrated very few false positives and had a specificity of 99.9%.
Author Karen Lu, MD, professor of gynecologic oncology at the University of Texas M.D. Anderson Cancer Center in Houston reported her findings during a presscast that previewed several presentations from the forthcoming American Society of Clinical Oncology (ASCO) 46th Annual Meeting.
“The beauty of the algorithm is that each individual woman ultimately established her own baseline, based on her prior CA-125 values. The incidence of ovarian cancer in postmenopausal women is 1 in 2500; it is the most lethal gynecologic cancer. Unfortunately, more than 75% of cases present with advanced-stage disease, when cure rates are less than 30%. If a diagnosis is made at an early stage, then outcomes are generally much better, with reported cure rates of 60% to 90%.”
The ROCA offers 3 possible pathways. Women at low risk will return for an annual CA-125 blood screening, women at intermediate risk will have their CA-125 test repeated in 3 months, and women at high risk will be referred for TVS and clinical evaluation.
Overall, the ROCA provided a positive predictive value of 37.5% (the chance of having ovarian cancer with a positive ROCA test or true positives). The combined specificity of ROCA followed by TVS for referral to surgery was 99.7% (the chance a negative test result is correct).
Dr. Lu emphasized that “it is important to stress the clinical ramifications of the study; it is not practice changing at this time. We await the results of the definitive trial that examines mortality as an end point, which is currently ongoing in the United Kingdom.”
A large-scale study of the ROCA is currently underway and involves more than 200,000 women. Results are expected in 2015.
J. Kyle Mathews, MD
Plano OB Gyn Associates
Plano Urogynecology Associates
Tags: CA 125, cancer, disease, gynecologic, Gynecology, kyle mathews, New Ovarian Cancer Screening Approach, Oncology, ovarian, Ovarian Cancer, Overall, ROCA, TVS, Ultrasound, women | Category: Gynecology, Menopause, News & Education |