Two-Step Screening Detects Early-Stage Ovarian Cancer
(HealthDay News) – A two-step screening process using the Risk of Ovarian Cancer Algorithm (ROCA) followed by transvaginal ultrasound (TVS) for those at high risk, shows high specificity in early detection of ovarian cancer in postmenopausal women, according to a study published online Aug. 26 in Cancer.
Karen H. Lu, MD, of the University of Texas MD Anderson Cancer Center in Houston, and colleagues followed 4,051 postmenopausal women over 11 years using an annual CA125 test and ROCA to triage women to the next annual CA125 test (low risk), a repeat CA125 test at three months (intermediate risk), or TVS and referral to a gynecologic oncologist (high risk).
The researchers found that the annual rates of referral averaged 5.8% for a CA125 test in three months and 0.9% for TVS and review by a gynecologic oncologist. On the basis of TVS, 10 women underwent surgery, and four invasive early-stage ovarian cancers were detected (one stage IA, two stage IC, and one stage IIB) for a positive predictive value of 40%. Specificity for the two-step screening strategy was 99.9%.
"The results from our study are not practice-changing at this time; however, our findings suggest that using a longitudinal (or change over time) screening strategy may be beneficial in postmenopausal women with an average risk of developing ovarian cancer," Lu said in a statement.
Several authors disclosed financial ties to the medical diagnostics industry; one author is a co-inventor of ROCA.