Simple Blood Test Can Assist in Early Dectection of Ovarian Cancer

As much as 80 percent of ovarian cancer can be diagnosed in the earliest and most curable stages with the use of a symptoms checklist combined with a simple blood test, according to a a group of researchers at Fred Hutchinson Cancer Research Center. More than 21,000 women are diagnosed with ovarian cancer annually, and more than 15,000 women die from the disease each year, according to the American Cancer Society (ACS).

Ovarian cancer has long been called the silent killer, since the disease was believed to exhibit no symptoms until it reached very late stages. Yet survivors of ovarian cancer are adamant that they were very aware that something was wrong before being diagnosed with the disease. In an earlier study, University of Washington researcher Barbara Goff, M.D., and colleagues analyzed patient's complaints and found that ovarian cancer is not the soundless assasin it was thought to be.

Dr. Goff, M. Robyn Andersen, Ph.D., and colleagues came up with an ovarian cancer symptom-screening index tool, in an effort to help clarify if women might have a heightened risk of ovarian cancer. However, the index only found 57 percent of early-stage malignancies.

Another method used in detecting ovarian cancer is a blood test that looks for CA 125, a protein that is often elevated in ovarian cancer. However, CA 125 can sometimes be elevated in women who don't have ovarian cancer and in prior studies, the blood test for CA 125 levels alone have been able to detect only about 50 percent of clinically detectable, early-stage ovarian cancer cases.

The research group has now found that combining the symptom-screening tool with the ovarian-cancer CA 125 levels blood test can catch more than four out of five early ovarian cancers. The study consisted of 254 healthy women at high-risk for ovarian cancer due to family history and 75 women about to undergo surgery to remove a malignancy. The women filled out questionnaires regarding symptoms and gave a blood sample for levels of CA 125 to be measured. The two methods combined correctly identified roughly 90 percent of the ovarian cancers with 80.6 percent being early cancers and 95.1 percent being late-stage cancers. About 14 percent of the women who had symptoms and elevated levels of CA 125 did not have ovarian cancer. The women received transvaginal ultrasound tests as a follow-up.

The symptoms that may be a warning of ovarian cancer are not specific and most often appear to be gastrointestinal or psychological rather than gynecological in nature. However, symptoms such as pelvic or abdominal pain, bloating, increased abdominal size, difficulty eating, or feeling full quickly can be indicative of ovarian cancer when they occur more than 12 times per month and have begun occurring within the past year. The frequency and length of these symptoms would indicate a positive on the symptom-screening tool. Only 2 percent of women report recent, frequent onset of these symptoms. "This isn't something that's been going on since a woman was 18," Andersen says. "This is something new happening to a woman's body."

If a woman is found to be high risk through the use of the symptom index or CA 125 testing, a transvaginal ultrasound would most likely be suggested to check for abnormal growths on her ovaries. These growths are not uncommon and the ultrasound is not an actual test for ovarian cancer. "But if ultrasound is used in the group of women already selected because of symptoms or CA 125 or both, then we might identify which women are the right ones to go to surgery," Andersen says. "We want to use transvaginal ultrasound to identify the false-positives among women who did report symptoms, so those who don't have ovarian cancer would not go to surgery."

The only sure way to know if a woman has ovarian cancer is with surgery, which is no routine matter. This is what makes finding a reliable way to detect cancer of the ovaries so important. Currently more than 70 percent of women are diagnosed with advanced stage three or four ovarian cancer that can only be cured in 20 to 30 percent of these cases. The combination of the symptom-screening tool and the CA 125 blood test may be the best available detection method found to date.