Major ovarian cancer screening trial fails to show any reduction in deaths

Screening the population regularly for ovarian cancer did not reduce deaths from the disease, a UK study has found.

More than 200,000 women underwent annual screenings over 16 years as part of the trial but this didn’t translate into more lives being saved, scientists said.

Two screening methods were used: a yearly ultrasound scan, or an annual blood test alongside the ultrasound scan – known as multimodal screening.

The findings, published in the journal The Lancet, showed that while multimodal testing picked up some cancer cases at an early stage, neither screening method reduced deaths.

As a result, experts said they cannot recommend regular ovarian cancer screening for the general population using the two existing methods – but added those experiencing symptoms should consult their doctor so they can get early access to treatment, if needed.

Professor Mahesh Parmar, director of the Medical Research Council clinical trials unit at University College London, and a senior author on the paper, said: "There have been significant improvements in the treatment of advanced disease in the last 10 years, since screening in our trial ended.

"Our trial showed that screening was not effective in women who do not have any symptoms of ovarian cancer; in women who do have symptoms early diagnosis, combined with this better treatment, can still make a difference to quality of life and, potentially, improve outcomes.

"On top of this, getting a diagnosis quickly, whatever the stage of the cancer, is profoundly important to women and their families."

More than 4,000 women die from ovarian cancer each year in the UK.

The disease is hard to detect in its early stages due to its vague symptoms, such as constipation, bloating, feeling full quickly when eating and back pain.

The trial was designed to see whether the existing screening methods could cut deaths by picking up ovarian cancer earlier, when treatments are more likely to be effective.

Women aged 50-74 were enrolled in the trial between 2001 and 2005 and randomly allocated to one of three groups: no screening, vaginal ultrasound screening, and multimodal screening.

The blood test in the multimodal screening measures levels of a protein called CA125 that is often elevated in the blood of women who have ovarian cancer. The ultrasound scan is used to look for abnormalities in the ovaries.

Around 39% more early-stage cancers were detected through blood test screening, the researchers said, compared with the no-screening group.

There was no difference in the stage of cancers detected in the ultrasound group compared with the no screening group, they added.

Professor Usha Menon, of the Medical Research Council clinical trials unit at University College London and lead investigator of the trial, said: "We are disappointed as this is not the outcome we and everyone involved in the trial had hoped and worked for over so many years.

"To save lives, we will require a better screening test that detects ovarian cancer earlier and in more women than the multimodal screening strategy we used."

Commenting on the research, Michelle Mitchell, Cancer Research UK’s chief executive, said: "Trials don’t always find the result we had hoped for, but we need long-term studies like this to know whether new tests save lives."

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