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May 20th, 2010
08:08 PM ET

Study: Screening for ovarian cancer may be closer

By Miriam Falco
CNN Medical Managing Editor

(CNN) Researchers may have found an effective way to screen for ovarian cancer by using an existing blood test in a new way, according to a study released Thursday by the American Society of Clinical Oncology).

Ovarian cancer is often called the silent killer because there is no good equivalent screening tool, like mammograms are for breast cancer. Dr. Douglas Blaney, ASCO president, calls this cancer vicious because it's usually detected after it can be cured with surgery.

For more than two decades, doctors have known that a protein called CA-125, is much more prevalent in ovarian cancer cells than healthy cells.

A blood test that looks for CA-125 is used to determine whether an ovarian cancer patient's treatment is working. However, the CA-125 test hasn't been an effective screening for ovarian cancer because many women who have high levels of this protein don't actually have cancer.

"For the last 10 years, the ovarian cancer community has been interested in screening for new [cancer] markers," says lead author Dr. Karen Lu from the M.D. Anderson Cancer Center in Houston, Texas. But when researchers compared all the new markers for ovarian cancer at a cancer conference last year, Lu says, of all the new markers, the old one – CA-125 was the best.

So Lu and her co-authors developed mathematical way to determine how the old test could be used in a new way.

For eight years, researchers followed over 3,200 postmenopausal women age 50 and older who didn't have a family history of the disease.

They started by testing the women's CA-125 levels. Based on the woman's age and depending on how high those levels were, the women were asked to get their next blood test one year later, to wait three months, or If their levels were high, they were immediately referred to ultrasound screening and a surgeon.

"What these folks are trying to do is look at change over time," explains Dr. Otis Brawley, chief medical officer of the American Cancer Society, who was not involved in the study.

Using criteria developed by the researchers, 82 percent of the women had low CA-125 levels and were told to come back in a year. They were classified as low risk.

Over the course of the study, about 7 percent of the women were judged to be at intermediate risk based on their protein levels and were asked to get tested every three months. And less than 1 percent were at high risk and sent to get an ultrasound and see a surgeon immediately.

Five women were found to have ovarian cancer, all at an early stage.

The study authors say their work provides early evidence that this new method of using the CA-125 test could be a feasible strategy for screening women over 50 years of age.

Blaney describes the results as a more refined application of known test.

Lu was cautiously optimistic about the study because it found very few false positive results and doctors were able to pick up this very aggressive cancer at an early stage giving women a much better chance of survival.

However, this study will not lead doctors to recommend all women start getting this blood test once they hit the age of 50 – at least not yet.

Because ovarian cancer is so rare, a much larger trial is needed says Lu. Ovarian cancer strikes one in 2,500 post-menopausal women – and one in 10,000 women between the ages of 35 and 50.

The definitive study is being done in the United Kingdom," say Lu.

This study involves 200,000 women and is designed to determine whether lives are actually saved by using this new application of the old test.

Results from this trial are expected in four years.

"Four years is pretty fast" says Lu.


soundoff (35 Responses)
  1. Claudette Siar

    Last year my 54 years old sister Deborah died of ovarian cancer. This test is a simple way of identifying early high cancer cells and can be done in regular annual blood work. I have been able to have the CA-125 done in my blood work. However, insurance companies object to this simple additional test that could save lives. This is an almost symptomless disease and a killer. Women demand a CA-125 in your annual blood work, it could save your life with early diagnosis.

    May 20, 2010 at 20:37 | Report abuse | Reply
  2. Jennifer

    My sister passed away last year (Oct. 9th) from Ovarian Cancer, she was 33, she had been battling it for 4 years, she had a very rare type, and no chemotherapy worked, she was never in full remission for the 4 years. I hope they find a chemo that can handle the rare types, that are just that, rare, but out there. Hearing news like this bring hope to the families of loved ones lost by this cancer. RIP Jesica

    May 20, 2010 at 21:25 | Report abuse | Reply
  3. Kimberly Ann Hill-Suarez

    In 2006 I lost my sister at age 49 to ovarian cancer. It is good to know that the existing CA-125 test can be used in this way. I hope that research continues. This cancer, as so many others, is tenacious.

    May 21, 2010 at 00:52 | Report abuse | Reply
  4. PMaxwell

    I saw a list of risk factors for ovarian cancer that included a history of no pregnancies and long-term hormone use. Perhaps women with these risk factors could be followed with the CA-125 test more often than the norm.

    May 21, 2010 at 00:53 | Report abuse | Reply
  5. lourdes

    Are you aware that ovarian leiomyosarcoma does NOT show in any blood test! it can only be found through imaging!!! please, make the public aware!

    leiomyosarcoma is a soft tissue sarcoma, very virulent. no leiomyosarcoma is diagnosed through blood work!

    May 21, 2010 at 03:48 | Report abuse | Reply
  6. kristina

    Wonderful news! Ovarian cancer runs in my family, my grandmother bravely fought it for ten years and lost the battle January of 2009. Miss her so much. I hope they make progress on how to detect and fight this cancer.

    May 21, 2010 at 04:12 | Report abuse | Reply
  7. Richard

    I am so glad to hear this news because ovarian cancer killed my mother who was 91 and evidently had signs of this condition for about a year before the doctors at Johns Hopkins Hospital in Baltimore made a definite diagnosis. Howerver, they said the same thing this article says, by the time it is detectable it its to late.

    May 21, 2010 at 06:01 | Report abuse | Reply
  8. Maria

    Please revise this page, surgery by no means cures ovarian cancer. That statement is misleading and false

    May 21, 2010 at 08:25 | Report abuse | Reply
  9. Lynette

    I am an oncology nurse and I was wondering if there is any new information on the HE4 blood test that shows promise for ovarian cancer screening.

    Thank-you,
    Lynette R.

    May 21, 2010 at 09:08 | Report abuse | Reply
  10. Laurie

    At 37, I was diagnosed with Stage 1A ovarian cancer. My CA-125 levels were normal. This test is not good enough. The cancer was found with my own instistence that something wasn't right with my body.

    May 21, 2010 at 09:22 | Report abuse | Reply
  11. Cindy

    I'm so happy to finally see an article on ovarian cancer!!!! This deadly disease gets little to no attention and it continues to kill our mothers, daughers and sisters. Thank you so much to those who on a daily basis contribute to research and better ways in detecting this silent killer.

    May 21, 2010 at 09:32 | Report abuse | Reply
  12. Kathy Loncke

    I find this very interesting, I have had the CA-125 test for the past three years since my mother died of ovarian cancer at the age of 53. I was wondering what the risks of ovarian cancer are as you get older. I am 58 and well past menopause and wonder if I am still at risk? Any one have any thoughts or knowledge on this issue?

    Thank you

    May 21, 2010 at 09:54 | Report abuse | Reply
    • Jennie

      Kathy, you're at risk for ovarian cancer if only because of your age. Risk of Ovarian cancer increases with age, obesity, nulliparity (i.e. not having birthed children), use of certain hormones, etc. Do a google search for Vitamin D and see what you think. There's more and more info becoming available as to the importance of this particular hormone type vitamin in helping to prevent cancers. I work as a family nurse practitioner in the Great Lakes region and am amazed at how many people are deficient in D, primarily from lack of sun exposure. During fall, winter and spring I supplement with 1,000 to 2,000 units per day of D3. Just a suggestion, I'm sure some won't agree, but do your own research, ask your own provider and then consider using this to help support your health. Blessings, Jennie

      June 27, 2010 at 18:54 | Report abuse |
  13. Renee Gossett

    I realize that most women who have ovarian cancer are older. But, it can and did happen to our 11 year old daughter back in 1993. We had no clue that this could happen to a young girl just going through puberty, but that is exactly what happened in her case. She was diagonised in July 1993, after numerious surgeries and a bone marrow transplant.; she lost in fight on September 2, 1994.

    May 21, 2010 at 11:29 | Report abuse | Reply
  14. CBA

    I took the initiative to ask for a CA-125 test in May '09. It was 4. (normal is 0-35) I missed my October annual physical. In Feb '10, I experienced some problems which finally sent my to a gynecologist in March. My CA-125 was then 75, and other tests showed problems. I've since been diagnosed with Stage IIC ovarian cancer. I'm lucky that it was only stage II. So far, the CA-125 test is probably the best chance at finding an indication of ovarian cancer. However, the best chance women have of not allowing this cancer to grow and spread is to have annual check-ups with a gynecologist, INSIST on getting a CA-125 test- even if you have to pay for it yourself, and to really pay attention to the changes in your body. The symptoms can be fairly vague, and most women might just blow them off because of that.. But each woman knows her body best, and if you think something isn't right, or there are changes that weren't there before, don't be afraid to talk to your doctor about it.

    May 21, 2010 at 11:30 | Report abuse | Reply
  15. Janice Zenor

    My CA-125 test was negative and I had an ovarian cyst the size of a small melon. It was cancerous. The majority of other ovarian cancer patients I have talked to have negative CA-125 tests also.

    May 21, 2010 at 12:41 | Report abuse | Reply
  16. Steve F

    CA-125 does not detect squamous cell carcinoma. Your story should be titled "Screening for some ovarian cancer....."

    May 21, 2010 at 13:24 | Report abuse | Reply
  17. Kristy

    I'm 27, and I have had 5 ovarian tumors to date. I have been lucky in that all of them have so far been benign, but Ovarian cancer is by biggest fear. We must find a way to detect this disease while something can still be done to save the patient.

    May 21, 2010 at 14:14 | Report abuse | Reply
  18. Linda Hiemstra

    Early detection is key in cancer diagnosis. I am a 13 year ovarian cancer survivor (stage 1A). My journey toward a diagnosis started with having my gallbladder removed in February '97 and at my annual physical in June '97 a urinary infection would not clear. My family doctor did not give up and his persistence means that I will see my son be married in June along with many other memorable moments. Life is a gift!!!.

    May 21, 2010 at 14:25 | Report abuse | Reply
  19. mcbrideba

    I was diagnosed with ovarian cancer at age 21. After having some pain, my ob/gyn found the tumor through an ultrasound. He ordered the CA-125 and it came back at 377. It should be between 11-13. I was referred to my oncologist who preformed the surgery to remove the ovary with the tumor. This year is my 10th year cancer free. Thank goodness for the CA-125, it really helped my situation.

    May 21, 2010 at 16:01 | Report abuse | Reply
  20. Lisa Huston

    I had a "fist sized mass" on my right ovary found through an abdominal CT. I had a CA-125 test done and it came back really high, but it turns out it was not ovarian cancer, but rather an endometrioma that had ruptured and spewed tissue and blood into my abdominal cavity. The elevated CA-125 was due to the inflammation, my surgeon told me. The test is useful, but certainly not definitive!

    May 21, 2010 at 16:22 | Report abuse | Reply
  21. Judy Wolfe

    My mother passed from ovarian cancer at 89...Her "dimwit Dr." was shocked....He said "little old ladies" don't have ovaries....

    May 21, 2010 at 16:23 | Report abuse | Reply
  22. Theresa S.

    It's not as "rare" as they say... 1 in 57 women is the real stat. I was diagnosed at 43 yrs old. Until the CA-125 gets better, or applies to younger women, vague symptoms are STILL the way to detect. Symptoms are subtle and persistent, and usually increase over time.
    Bloating
    Pelvic or abdominal pain
    Difficulty eating or feeling full quickly
    Urinary symptoms (urgency or frequency)
    Pay attention women – don't rely on a far-off future date when this test will work for you!

    May 21, 2010 at 16:41 | Report abuse | Reply
  23. Shereef Elnahal

    These researchers would do worlds for women who are at risk for this cancer. As a doctor in training, I've yet to see a diagnosis of ovarian cancer without a grim prognosis. I am really hoping this pans out as an effective screening tool.

    Please visit my blog on the business of health care in America:
    http://www.shereefelnahal.com

    May 22, 2010 at 01:55 | Report abuse | Reply
  24. Chuck

    Please find a good test for this, My wife(63) and my daughter(40) are fighting this silent disease as I type this. My wife is undergoing her second bout with it and my daughter just finished her first. Please say a prayer for them.

    May 22, 2010 at 07:47 | Report abuse | Reply
  25. Odalice feliz

    My aunt has been affected by cancer but through doctors help she has recoverd!!! Peace Love and Happiness to her!!!!

    May 22, 2010 at 11:34 | Report abuse | Reply
  26. Charles Irwin

    My wife died this year in March of Ovarian Cancer. She was not diagnosed with it until August of 2009 when she started bleeding from the rectum. A colonoscopy showed she had a tumor in the colon which was diagnosed as Ovarian Tumor with pathology tests. A subsequent MRI showed she had two large tumors, one in the lower pelvic area and one in the upper abdomen. Finally, she was given a CA-125 Blood test which showed high levels.....too late to do her any good! NO DOCTOR OR MEDICAL PROFESSIONAL EVER MENTIONED TO HER TO BE CHECKED FOR OVARIAN CANCER This is a big mistake by the medical field and I sincerely hope it will be corrected as soon as possible

    May 22, 2010 at 12:17 | Report abuse | Reply
  27. DEB

    I am proof that by not getting regular checkups and ignoring symptoms that I was first diagnosed with Stage 3 Ovarian Cancer at age 43. Please use any current forms of testing and get regular checkups to prevent or catch it early.

    May 22, 2010 at 12:21 | Report abuse | Reply
  28. mary macvicar

    When I was on statins, I had a severe reaction – to the point where I could not walk. at that time my CK was tested and was quite high ,After stopping all medications, I have since regain ambulatory status, but am still plagued with easy muscle fatigue. Is there anything I can do to improve my muscle tone – after hearing my problems my friends are reluctant to take statins.

    Thank you for any suggestions.

    May 23, 2010 at 09:10 | Report abuse | Reply
  29. Carol

    How many of the women diagnosed were BRCA1 or BRCA2 positive? Are there any current/past clinical trials combining the genetic mutation and CA-125 indicators?

    May 24, 2010 at 11:49 | Report abuse | Reply
  30. Dede

    The emergency room visit, after being hit by a 150/mph boomerang foul ball at a Ranger game in '05, was where my partner received her cancer diagnosis. Soon after, Stage IIIc ovarian cancer, was the gynocologic surgical oncologist's confirmation. Prior to that day, there was never any discussion of her family's cancer history – but before the week was out it was revealed there had been many prostate, breast and ovarian cancers on both sides of her family. Until a viable screening test is available to women, WE must be: proactive in learning our family history of cancer; responsible for passing this information on to our gynocologists and, when symptoms are whispering, be relentless in getting to their underlying cause. Jenny would be so pleased to know the quest for a reliable screening tool is on the front burner!!

    May 29, 2010 at 18:46 | Report abuse | Reply
  31. sherlin1234

    Ovarian cancer is often called the silent killer because there is no good equivalent screening tool. A blood test that looks for CA-125 is used to determine whether an ovarian cancer patient's treatment is working, but its not always true in all cases.

    http://www.justcancer.org/ovarian-cancer-diagnosis.html

    June 14, 2010 at 02:35 | Report abuse | Reply
  32. Tanna Linwood

    Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is difficult to treat and is often fatal. `-":

    Best wishes
    <http://picturesofherpes.co

    June 30, 2013 at 21:06 | Report abuse | Reply
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