Ovarian cancer screening fails to reduce deaths

CANCER DIGEST – May 15, 2021 – One of the largest trials ever conducted to screen women for ovarian cancer failed to reduce deaths from the disease, a new analysis shows.

The UK Collaborative Trial of Ovarian Cancer Screening followed more than 200,000 women ages 50 to 74 for an average of 16 years. A third of the women underwent no screening, a third underwent annual ultrasound screens and the final third underwent blood tests and ultrasound scans.

In the analysis published in the May 12, 2021 journal The Lancet showed that despite detecting ovarian cancer earlier screening did not translate into saving lives. The study was led by researchers at the University College London.

“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," said lead investigator Usha Menon in a press release. "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.”

The women enrolled in the trial beginning in 2001 and screening went on until 2011 involving 50,000 women randomly assigned to receive an annual blood test that monitored the level of a protein marker of cancer, 50,000 assigned to a yearly ultrasound, and 100,000 women who received no screening.

The analysis of the results showed that the blood test picked up 39% more early stage cancer but 10% fewer late-stage cancers compared to the no screening group. There was no difference in the stage of cancers detected in the ultrasound group compared to the no screening group.

Ultimately roughly the same number of women in each group died of ovarian cancer. A total of 1206 women in the study died of the disease with 296 (0·6%) of 50,625 in the blood and ultrasound group, 291 (0·6%) of 50,623 in the ultrasound only group, and 619 (0·6%) of 101,314 in the no screening group.

“Population screening for ovarian cancer can only be supported if a test is shown to reduce deaths in a future randomized controlled trial," said co-investigator Professor Ian Jacobs said in the press release. "I remain hopeful that a new effective screening test will be found eventually, but it will take many years to conduct a large trial of the test. Realistically, this means we have to reluctantly accept that population screening for ovarian cancer is more than a decade away.”


Sources: University College London press release and The Lancet