Can we diagnose ovarian cancer early with symptoms-triggered testing?
You may have seen in the news that researchers have been exploring whether testing women with symptoms that might be linked to ovarian cancer is a good way to find aggressive types of the disease early.
“Finding ovarian cancer at its earliest stage gives women the best chance of surviving this disease. But it is also one of our hardest challenges with no screening tool and too many women diagnosed late.
This research shows that symptoms awareness is still important and can help some women receive an earlier diagnosis while we fund research into making screening a reality. Only then will we see a significant shift where the majority of women have an early diagnosis.”
The NHS has been offering quick tests for ovarian cancer based on symptoms since 2011. However, until now, it wasn't clear how well this method worked in finding the most common and aggressive type of ovarian cancer, called high grade serous ovarian cancer, in its early stages (Stage 1 or 2).
Catching ovarian cancer early is important because treatment is more likely to work.
The NHS has been offering quick tests for ovarian cancer based on symptoms since 2011 but only now can we analyse the results.
What is symptom-triggered testing?
Symptom-triggered testing means doctors arrange diagnostic tests for ovarian cancer, for example a CA-125 test or ultrasound, when certain symptoms are reported. The National Institute for Health and Care Excellence (NICE) suggests that doctors should test women, as well as some transgender men and non-binary people assigned female at birth, who have certain symptoms 12 or more times a month, especially if they are over 50 years old.
These symptoms include:
Swelling or bloating in the abdomen (tummy)
Feeling full quickly or loss of appetite
Pain in the abdomen
Needing to wee more often or urgently
When someone has these symptoms, they are given a blood test to check the levels of a protein called CA125. This protein is made by ovarian cancer cells. If the test shows high levels of CA125, the person might also have an ultrasound scan. If the results are unusual, they are sent to a hospital to see a gynecologist (a doctor who specializes in women's health) within two weeks.
What happened in the study?
To learn more, researchers at the University of Birmingham looked at data from 1,741 women in a study called the Refining Ovarian Cancer Test accuracy Scores (ROCkeTS). The study took place in 24 hospitals across the UK.
What was the outcome of the study?
They found that 1 in 4 women diagnosed using symptom-triggered testing had Stage 1 or 2 (early stage) high grade serous ovarian cancer. Finding the cancer in these women early meant they had a much better chance of surviving for 5 or more years than if they were diagnosed at Stage 3 or 4 (late stage).
Even women with later-stage cancer benefitted from the quick testing. Most of them were able to have surgery that removed all or almost all of their tumors.
In total, surgery removed all visible signs of cancer in 2 out of every 3 women diagnosed with high grade serous ovarian cancer after symptom-triggered testing. Fewer than 1 in 10 women diagnosed this way had cancers that were too advanced to treat with surgery.
What do the results mean for ovarian cancer diagnosis?
The results show that knowing the symptoms of ovarian cancer can help some people have the best chance of survivng their disease.
But it also showed that 3 out of 4 women already had late stage disease when their symptoms triggered a diagnosis.
For this reason, Ovarian Cancer Action is committed to funding research to make an ovarian cancer screening test a reality. We won’t stop until all women can benefit from an early diagnosis.
What to do if you're experiencing ovarian cancer symptoms?
Ovarian cancer symptoms include bloating, peeing more often, tummy pain and feeling full quickly. If your symptoms are persistent, severe, frequent or out of the ordinary make an appointment with your GP as soon as possible.
Keep a record of the symptoms you are experiencing and have your notes to hand when you speak to your doctor, to help them make a diagnosis. Use our downloadable symptoms diary to help you keep track of your symptoms.