Download Press Release Release date: Monday 4th May New screening

Press Release
Release date: Monday 4th May
New screening technique could pick up twice as many women with ovarian
cancer
A new screening method can detect twice as many women with ovarian cancer as
conventional strategies, according to the latest results from the largest trial of its
kind led by UCL.
The method uses a statistical calculation to interpret changing levels in women’s
blood of a protein called CA125, which is linked to ovarian cancer. This gives a more
accurate prediction of a woman’s individual risk of developing cancer, compared to
the conventional screening method which uses a fixed ‘cut-off’ point for CA125. The
new method detected cancer in 86% of women with invasive epithelial ovarian
cancer (iEOC), whereas the conventional test used in previous trials or in clinical
practice would have identified fewer than half of these women (41% or 48%
respectively).
The results come from analysis of one arm of the UK Collaborative Trial of Ovarian
Cancer Screening (UKCTOCS), the world’s largest ovarian cancer screening trial, led
by UCL and funded by the Medical Research Council, Cancer Research UK,
Department of Health and The Eve Appeal. The trial involved 202,638 postmenopausal women aged 50 or over who were randomly assigned to two different
annual screening strategies (multimodal screening or transvaginal ultrasound) or no
test at all.
The study, published in the Journal of Clinical Oncology, evaluated 46,237 women
who continued to attend annual multimodal screening following the first screen.
Their blood was tested once a year for CA125 levels and then a computer algorithm
was used to interpret their risk of ovarian cancer based on factors including the
woman’s age, the original levels of CA125 and how that level changed over time. The
serial pattern was compared with known cases of cancer and controls to estimate the
risk of having ovarian cancer.
Professor Usha Menon, UKCTOCS co-principal investigator and trial co-ordinator at
UCL, who has led the implementation of this 14 year trial, says:
“There is currently no national screening programme for ovarian cancer, as research
to date has been unable to provide enough evidence that any one method would
improve early detection of tumours. These results are therefore very encouraging.
They show that use of an early detection strategy based on an individual’s CA125
profile significantly improved cancer detection compared to what we’ve seen in
previous screening trials.
“The numbers of unnecessary operations and complications were within acceptable
limits and we were able to safely and effectively deliver screening for over a decade
across 13 NHS Trusts. While this is a significant achievement, we need to wait until
later this year when the final analysis of the trial is completed to know whether the
cancers detected through screening were caught early enough to save lives.”
Professor Ian Jacobs, currently President of The University of New South Wales,
Australia, the chief investigator of UKCTOCS and co-inventor of the statistical
approach, who conceived the trial, says:
“CA125 as a biological marker for ovarian cancer has been called into question. Our
findings indicate that this can be an accurate and sensitive screening tool, when
used in the context of a woman’s pattern of CA125 over time. What’s normal for one
woman may not be so for another. It is the change in levels of this protein that’s
important. My hope is that when the results of UKCTOCS are available this approach
will prove capable of detecting ovarian cancer early enough to save lives.”
Previous large ovarian cancer screening trials have used a fixed cut-off for CA125
(more than 35U/mL) to identify a possible abnormality. But some women can have
much higher levels and not have the cancer, while others with levels below this
threshold could be harbouring the disease.
A total of 640 women in the MMS group had surgery for suspected cancer, of whom
133 women had invasive epithelial ovarian cancers (iEOC). A further 22 women were
diagnosed with iEOC within a year of the last annual screen. Results of screening in
the ultrasound arm and the impact of screening on ovarian cancer deaths are
anticipated later this year.
Professor Patrick Maxwell, Chair of the MRC’s Molecular and Cellular Medicine Board
and Head of the School of Clinical Medicine of the University of Cambridge, says:
“The UKCTOCS trial is a powerful demonstration of the type of research that thrives
in the UK, where our best scientists, clinical researchers and healthcare workers work
together and involve volunteers nationwide to improve health. These exciting initial
results could eventually go on to form the basis of a national screening programme
for ovarian cancer.”
Dr James Brenton, Cancer Research UK’s ovarian cancer expert, says: “A blood test
to find women at risk of ovarian cancer is an exciting prospect, but this work still
needs to be tested in women to see if it can save lives. By tracking how the levels of
the CA125 protein change over time we might have an early signal to detect
tumours. Ovarian cancer is particularly hard to spot at an early stage so it’s vital that
we find ways to diagnose the cancer sooner.”
Athena Lamnisos, Chief Executive Officer of the Eve Appeal, says: “The ‘C’ in
UKCTOCS stands for ‘collaborative’ and is a key aspect of both the name, and the
ethos, of this trial – it is a powerful partnership of researchers, clinicians and of
course the women who volunteered. The statistics around ovarian cancer are brutal
and diagnosis often comes too late – either because a woman hasn’t recognised the
symptoms or because her GP doesn’t. Our ambition is that this approach will be
capable of detecting ovarian cancer at an earlier stage and save lives. These latest
results are exciting and point towards the strides that we’re making in more
accurately predicting individual risk of developing cancer.”
-EndsNotes to Editors
To speak to one of the spokespeople or for a copy of the paper, please contact Wesley
Hutchins, Communications Officer at The Eve Appeal on 0207 605 0108 or via email
[email protected]. Alternatively, please contact Athena Lamnisos, Chief
Executive at The Eve Appeal on 0207 605 0151 or via email
[email protected].
Menon et al., ‘A risk algorithm using serial biomarker measurements doubles the number of
screen-detected cancers compared to a single threshold rule in the United Kingdom
Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)’, will be published in the Journal
of Clinical Oncology.
UKCTOCS is the world’s largest ovarian cancer screening trial. 1.2 million women across
England, Wales and Northern Ireland were invited to participate. 202,638 postmenopausal
women aged between 50 and 74 years who did not have a strong family history of OC were
recruited through 13 participating NHS Trust between 2001-2005. They were randomly
allocated to three groups: multimodal screening (50,640) or transvaginal ultrasound (50,639)
who underwent annual screening until December 2011; or to a control group (101,359) who
were not screened. The control group is in accordance with current NHS guidelines as there is
no evidence at present to support an ovarian cancer screening programme. 1 All women are
being followed up. http://www.ukctocs.org.uk/
The study is being run from the Gynaecological Cancer Research Centre, Women’s Cancer,
UCL EGA Institute for Women’s Health. It was funded by the Medical Research Council,
Cancer Research UK and Department of Health and is supported by gynaecological cancer
research charity The Eve Appeal and the National Institute for Health Research University
College London Hospitals Biomedical Research Centre.
The JCO paper does not report on cancers detected on the initial round of screening
(previously reported in Lancet Oncology 2009) or subsequently in women being screened in
the ultrasound arm or those in the control arm of the trial.
UCL (University College London)
Founded in 1826, UCL was the first English university established after Oxford and Cambridge,
the first to admit students regardless of race, class, religion or gender, and the first to
provide systematic teaching of law, architecture and medicine. We are among the world's top
universities, as reflected by performance in a range of international rankings and tables. UCL
currently has over 35,000 students from 150 countries and more than 11,000 staff. Our
annual income is more than £1 billion.
www.ucl.ac.uk | Follow us on Twitter @uclnews | Watch our YouTube channel
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The Eve Appeal
The Eve Appeal is the only UK national charity raising awareness and funding research in the
five gynaecological cancers – ovarian, womb, cervical, vaginal and vulval. It was set up to
save women’s lives by funding groundbreaking research focused on developing effective
methods of risk prediction, earlier detection and developing screening for these women-only
cancers. The charity has grown and developed in parallel with its core research team, the
Department of Women’s Cancer at University College London (UCL), and has played a crucial
role in providing seed funding, core infrastructure funding and project funding in addition to
campaigning to raise awareness of women-specific cancers. www.eveappeal.org.uk
UCL EGA Institute for Women’s Health
The Gynaecological Cancer Research Centre is part of the UCL Elizabeth Garrett Anderson
Institute for Women's Health, a joint venture between UCL (University College London) and
University College London Hospitals NHS Foundation Trust (UCLH). It brings together
individuals with expertise across the whole spectrum of women's health - from laboratory
science to clinical skills to social and behavioural sciences - with the objective of making a
major contribution to the health of women, both in the UK and internationally, by pioneering
research, education programmes and clinical initiatives.
http://www.instituteforwomenshealth.ucl.ac.uk/womens-cancer/gcrc
http://www.instituteforwomenshealth.ucl.ac.uk
Medical Research Council
The Medical Research Council has been at the forefront of scientific discovery to improve
human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’
money in some of the best medical research in the world across every area of health. Thirty
MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC
scientists have been behind such diverse discoveries as vitamins, the structure of DNA and
the link between smoking and cancer, as well as achievements such as pioneering the use of
randomised controlled trials, the invention of MRI scanning, and the development of a group
of antibodies used in the making of some of the most successful drugs ever developed.
Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in
the 21st century, from the rising tide of chronic diseases associated with ageing to the
threats posed by rapidly mutating micro-organisms. www.mrc.ac.uk
Cancer Research UK
Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through
research. Cancer Research UK’s pioneering work into the prevention, diagnosis and treatment
of cancer has helped save millions of lives. Cancer Research UK receives no government
funding for its life-saving research. Every step it makes towards beating cancer relies on
every pound donated. Cancer Research UK has been at the heart of the progress that has
already seen survival rates in the UK double in the last forty years. Today, 2 in 4 people
survive cancer for at least 10 years. Cancer Research UK’s ambition is to accelerate progress
so that 3 in 4 people will survive cancer within the next 20 years. Cancer Research UK
supports research into all aspects of cancer through the work of over 4,000 scientists, doctors
and nurses. Together with its partners and supporters, Cancer Research UK's vision is to
bring forward the day when all cancers are cured. For further information about Cancer
Research UK's work or to find out how to support the charity, please call 0300 123 1022 or
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