According to recent research, testing prompted by symptoms such as pain, abdominal swelling, and early fullness can identify early-stage aggressive ovarian cancer in 1 out of 4 individuals experiencing these symptoms.
A study in the International Journal of Gynaecological Cancer, funded by the National Institute for Health and Care Research, discovered that the UK’s approach to detecting early-stage disease in women with high-grade serous ovarian cancer— the most prevalent and deadly type of ovarian cancer— is an effective means of diagnosing even early-stage forms of the disease.
Furthermore, the research indicates that complete surgical removal of cancerous tissue is attainable, even in more advanced stages of the disease, provided that women exhibiting concerning symptoms are quickly referred for investigation and treatment.
A research team from the University of Birmingham examined data from 1,741 women participating in the Refining Ovarian Cancer Test accuracy Scores (ROCkeTS) study, which includes 24 hospitals across the UK. All participants were prioritized for treatment through the symptom-triggered testing rapid access pathway.
Sudha Sundar, a Professor of Gynaecological Cancer at the University of Birmingham and the Pan Birmingham Gynaecological Cancer Centre at Sandwell and West Birmingham Hospital NHS Trust, stated:
“Our data show that in a real-world context, testing based on symptoms can help diagnose high-grade serous ovarian cancer with limited spread of the disease and leads to a high rate of complete surgical removal.”
“These results challenge the belief that the disease automatically presents in advanced stages when symptoms arise in women.”
“Most importantly, our research highlights the need to raise awareness about ovarian cancer symptoms to ensure earlier diagnoses through the fast-track referral pathway, thereby improving patient outcomes.”
Key findings
Within the study, 119 (7%) participants were diagnosed with high-grade serous ovarian cancer, with an average age of 63, and 90% had experienced menopause.
For the majority of these women (112; 94%), the cancer had little impact on their daily activities, as they were rated with a performance status of 0 or 1—indicating they were either fully active or capable of everything except for vigorous activities.
One in four participants (30; 25%) had early-stage I or II disease.
Complete cancerous tissue removal occurred in 73 (61%) cases, while 18 (15%) had nearly all of it removed. Only 9 (8%) cases were declared inoperable.
The cancer stage was localized in the pelvis for 43 out of 119 participants (36%), moderately spread to the lower abdomen in 34 (29%), and highly spread to areas like the liver, pancreas, diaphragm, or spleen in 32 (27%). Data on disease extent was not available for 10 (8.5%) women.
Surgery aimed at removing as much tumor as possible—linked to longer survival—was performed on over three-quarters of the participants (93, 78%), with nearly two-thirds undergoing surgery before chemotherapy (78, 65%). Additionally, 36 (30%) received chemotherapy to reduce tumor size before surgery; 5 (4%) women did not have surgery, with information missing for 17 (14%) participants.
Testing adopted in 2011
The UK implemented symptom-triggered testing for ovarian cancer in 2011. Women, particularly those over 50 exhibiting these symptoms, undergo testing for the CA125 protein levels in their blood and receive an ultrasound scan. Abnormal results lead to a fast-track referral for a gynecological evaluation within two weeks.
Globally, ovarian cancer ranks as the seventh most common cancer among women and is the sixth leading cause of cancer-related deaths in the UK. While 93% of women diagnosed with early-stage disease (I or II) survive beyond five years, only 13% of those diagnosed with advanced disease (stages III or IV) achieve the same.
