News: Ovarian Cancer Action's statement on new research from the US that may improve early detection
Ovarian Cancer Action welcomes the findings of new research from the Fred Hutchison Cancer Research Center in the US, which indicates that women's reports of persistent symptoms linked to ovarian cancer — abdominal or pelvic pain, difficulty eating or feeling full quickly and abdominal bloating - when combined with the CA125 blood test, may improve the early detection of the disease.
Peter Reynolds, Chief Executive at Ovarian Cancer Action comments: "Earlier detection of ovarian cancer is critical to improving a woman's chance of survival, which remains shockingly low at 30% - a statistic that has hardly improved in over 20 years. This latest study from the US demonstrates the importance of symptoms in detecting ovarian cancer.
"Ovarian Cancer Action is committed to raising awareness of the symptoms of ovarian cancer and to undertaking research into the causes and treatments for the disease. It is vital that ovarian cancer is detected in women as early as possible, whilst we gain a greater understanding of why the disease occurs in the first place and how best to treat it."
Explanation of the study:
Members of the team that proved that most women diagnosed with ovarian cancer do experience symptoms – even in early stage disease have yet again backed up the argument for listening to women who are reporting symptoms.
Dr M Robyn Andersen led the team that broke the news on 23rd June 2008 that combining a symptoms index with the CA125 blood test can improve detection. We summarise the main findings for you here.
The Symptom Index
In an earlier study, Professor Barbara Goff found that most women who go on to get a diagnosis of ovarian cancer will report the following symptoms more than 12 times over a month and for less than a year.
The key symptoms are:-
Tummy or pelvic pain
Increased tummy size or bloating
Difficulty eating or feeling full
Needing to pass water suddenly or more often (this symptom although also associated with urinary tract infections was included in the early study as Professor Goff concluded that persistent urinary problems should be investigated).
Many of you will be familiar with the Symptom Index (a list of the above symptoms that women tick as appropriate over 4 weeks) and will have seen our article about it in our newsletter last year or read about it on our website. You may have indeed used the index yourself through downloading our Symptom Diary, which is based on Professor Goff's work.
Ovarian Cancer Action has been at the forefront of talking to the decision makers and GPs about the need to listen to women's reports of these symptoms and keep a track of their persistency and frequency in helping to decide who may need to go on for further tests.
This study set out to do a similar job in that it took the learning about the key symptoms from the earlier study and looked at how using them in combination with a CA125 blood test can help more accurately decide which women may need further tests.
The Women Taking Part
The women who took part used the Symptom Index to monitor which symptoms they had and how frequent they were over a four week period - urinary symptoms were not on the index for this study). The women also had the CA125 blood test.
So who were the women taking part in this study? A case control group of 254 'healthy' women who were at high risk because of their family history and 75 women who were undergoing surgery for pelvic masses who were later diagnosed with ovarian cancer.
The Theory Being Hypothesised
The researchers thought that the symptom index would identify women with cancer who do not have elevated levels of CA125 but might benefit from other tests.
Why Use CA125 Rather Than an Ultrasound Scan?
Many of you will be familiar with the ultrasound scan used to help detect ovarian cancer – the Trans l Ultrasound or TVU.
Although TVU is the gold standard in ultrasounds for checking out the ovaries, when used as a 'screening tool' a way of deciding who should have further tests including surgical diagnostics - laparoscopy, it produces a high rate of women whose ovaries look suspicious but may actually be healthy. It is usually used in the UK alongside the CA125.
The All Important Results of the Study
When the CA125 is used in combination with the Symptom Index* it is better at picking up possible ovarian cancers then when either tool is used alone. Indeed the combination identified more than 80% of women with early stage disease. The authors make the case that on the basis of their findings it might be possible to consider doing the CA125, Symptom Index and then depending on these results go through to TVU to help decide whether or not a woman should have a laparascopy.
* This time urinary symptoms were not on the list.
Why is this Important?
This latest research again puts women and their symptoms at the centre of the diagnostic process. It proves that tracking the persistency and frequency of symptoms is a useful indeed arguably an essential component of diagnosis.
Details of the Study
Robyn Andersen M; et al Combining a Symptoms Index with CA125 to Improve Detection of Ovarian Cancer, American Cancer Society, 2008 DOI 10.1002/cncr.23577
Anyone interested in reading the full article should go to www.interscience.wiley.com
Earlier Study
Goff B. A et al; Development of an Ovarian Cancer Symptom Index: Possibilities for Earlier Detection, Cancer, 2007