We know that lots of women have symptoms such as bloating and tummy discomfort. It is also very common to have cysts (balloon like swellings) on women’s ovaries picked up by ultrasound. A very small proportion of these women will go on to be diagnosed with ovarian cancer. The purpose of this study is to identify better tests for ovarian cancer. This may help us to diagnose more women with ovarian cancer early but also reduce unnecessary tests, hospital visits and distress in women who don’t have cancer.
National Institute for Health and Care Excellence (NICE), which is the body that establishes standards of care in the UK has issued guidelines to GP’s, to test women if they have symptoms of bloating/tummy discomfort with a blood test called CA125 and then a pelvic ultrasound if the CA125 test result is abnormal. However a published survey of 258 GP’s and a hospital audit suggest that GPs refer patients if they have symptoms or if either test is abnormal.
In fact the blood test CA125 can be raised in lots of other innocent conditions e.g. during menstrual periods. Also in younger women, non-cancerous cysts on the ovary are in fact very common. Conversely CA125 is only raised in half the women with early ovarian cancer. This means that many women are referred who actually have a very low risk of cancer, and others are not referred until their cancer has reached a more advanced stage.
Ovarian cancer affects 6500 women each year. Commonly 8 out of 10 women are diagnosed at an advanced stage of cancer, and have to undergo extensive surgery and chemotherapy. By identifying better tests for ovarian cancer, we may be able to diagnose more women with ovarian cancer early when they have a better chance of responding to treatment. We also know that women with ovarian cancer who are referred for thorough surgery by a gynaecological cancer specialist have the best outcomes, so this study may develop improved testing in hospital after referral to help to identify the patients who will need this. Equally, if we can clearly identify the women who have innocent cysts then they can be spared surgery or undergo surgery through key hole.