Screening For Ovarian Cancer
About ovarian cancer screening
Screening tests particular groups of people to find cancer early, when the chance of cure is highest. Before screening for any type of cancer can be carried out, doctors must have an accurate test to use. The test must be reliable in picking up cancers that are there. And it must not give results that make it look as though someone has cancer when they do not (false positive results).
At the moment, there is no screening test reliable enough to use to pick up ovarian cancer at an early stage. But there is a lot of research looking into this. The 2 main tests researchers have been looking at are
- CA125 blood test
- Transvaginal ultrasound
CA125 blood test
CA125 is known as a tumour marker for ovarian cancer. A tumour marker is a chemical given off by cancer cells that circulates in the bloodstream. Women with ovarian cancer tend to have higher levels of CA125 in their blood than women who do not have ovarian cancer. But there are some problems with this test that make it unsuitable for use as a screening test on its own
- Only about 85 out of every 100 women with ovarian cancer (85%) have raised CA125
- Only 50 out of every 100 women with early stage ovarian cancer (50%) have raised CA125
- Women with other conditions can also have raised CA125
So you can see that if this test was used on its own, it would miss some cases of ovarian cancer. It would also pick out other women who did not have ovarian cancer. They would then need to have further tests, which could cause them anxiety and harm. We need to have another test that can reliably show who has ovarian cancer and who hasn’t.
Researchers are looking for other possible tumour markers for cancer of the ovary. Doctors hope that by combining blood tests for markers they may be able to pick up more cancers and rule out people who don’t have cancer more easily.
This is an ultrasound examination done by putting the ultrasound probe into the vagina. It gives a better picture of the ovaries than an ultrasound over the abdomen. Even so, it can still be difficult to tell whether there is a cancer on the ovary or just a harmless cyst.
There is no clear evidence so far that these tests can pick up cancers early and save lives. Doctors are waiting for the final results of 2 large UK trials to be published in 2015. These trials looked at ovarian cancer screening in the general population and those at high risk of developing it.
Ultrasound (ultrasonography) is the use of sound waves to create an image on a video screen. Sound waves are released from a small probe placed in the woman’s vagina or on the surface of her abdomen. The sound waves create echoes as they enter the ovaries and other organs. The same probe detects the echoes that bounce back, and a computer translates the pattern of echoes into a picture.
Ultrasound is often the first test done if a problem with the ovaries is suspected. It can be useful finding an ovarian tumor and seeing if it is a solid mass (tumor) or a fluid-filled cyst. It can also be used to get a better look at the ovary to see how big it is and how it looks inside (the internal appearance or complexity). These factors help the doctor decide which masses or cysts are more worrisome.
If you would like to ask me about screening for ovarian cancer then please ask me today. Free email advice from a real doctor.
Dr Helen Webberley MBChB MRCGP MFSRH
GP and Reproductive Health Specialist
Dr Webberley is an NHS GP in South Wales and also runs a private General Practice service online.
- A woman’s risk of developing breast and/or ovarian cancer is greatly increased if she inherits a deleterious (harmful) mutation in the BRCA1 gene or the BRCA2 gene.
- Men with these mutations also have an increased risk of breast cancer, and both men and women who have harmful BRCA1 or BRCA2 mutations may be at increased risk of additional types of cancer.
- Genetic tests can check for BRCA1 and BRCA2 mutations in people with a family history of cancer that suggests the possible presence of a harmful mutation in one of these genes.
- If a harmful BRCA1 or BRCA2 mutation is found, several options are available to help a person manage their cancer risk.
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