Results from a large British clinical trial, which involved more than 200,000 post-menopausal women who were followed for more than 15 years, showed that screening average-risk, asymptomatic women for ovarian cancer does not reduce deaths from the disease. The results were published in the British medical journal, The Lancet.
The trial, called the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), is the largest trial of its kind in the world. Patients in the trial were randomized into three groups: 1) no screening, 2) annual screening with ultrasound, and 3) annual screening with ultrasound and CA-125 blood test (multi-modal screening).
Initial results of the trial reported five years ago seemed positive, and in this follow up, the multi-modal screening approach did identify more early-stage disease, with 39% more stage I and II cases being detected, and 10% fewer stage III or IV cases. Unfortunately, after 16 years of follow-up, researchers found that those earlier diagnoses did not translate into fewer deaths from the disease.
“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,” commented Usha Menon, MD, MRC Clinical Trials (MCT) Unit, Institute of Clinical Trials and Methodology, London, the United Kingdom, and lead investigator of the trial. “UKCTOCS is the first trial to show that screening can definitely detect ovarian cancer earlier. However, this very large, rigorous trial shows clearly that screening using either of the approaches we tested did not save lives,” she said in a statement.
“We therefore cannot recommend ovarian cancer screening for the general population using these methods,” she added.
The chair of OCRA’s Scientific Advisory Committee, Beth Karlan, MD, comments: “This is an outstanding trial with robust data. While we share in the disappointment of this outcome, this trial has provided us with vital insights on this important issue. We must now focus on new approaches, including new biomarkers, and testing modalities, to improve outcomes for women.”
Every research finding, including disappointing ones from “negative” trials like this one, advances our knowledge in the fight against ovarian cancer. In spite of the lack of effective screening for ovarian cancer, the incidence of ovarian cancer has been decreasing in recent years. Women have been living longer with the disease, and OCRA-funded researchers continue to make progress, searching for more effective methods of detection and better treatments. We will not stop until we find the answers and cure.