Systematic screening for ovarian cancer would lead to a reduction in mortality

Systematic screening for ovarian cancer would lead to a reduction in mortality

Routine screening for ovarian cancer could reduce long-term mortality from this uncommon but serious cancer, which is often diagnosed at an advanced stage, according to a large study published on December 17 in the British medical journal The Lancet.

“The results of the study show a reduction in mortality attributable to screening ranging from 15 to 28%”, specifies Professor Ian Jacobs, of University College London, who led the study carried out on more than 200,000 British women aged 50-74. Recruited between 2001 and 2005, they were followed until 2014 in thirteen centers spread throughout the United Kingdom.

Half of them received a screening : just over 50,000 were monitored thanks to a transvaginal pelvic ultrasoundannual while another 50,000 were subjected to a annual dosage of a specific “marker” of ovarian cancer called CA-125 in addition to ultrasound.

The other 100,000 women have not been screened. At the end of the follow-up, which lasted an average of ten years, 1,282 women had developed ovarian cancer; 649 died.

By comparing the deaths, the researchers showed a slightly lower mortality (ranging from 11 to 15%) among women who had undergone screening.

But above all they discovered that a early detection of cancer through screening reduced mortality “significantly” in the long term with a mortality reduced by 28% beyond seven years of follow-upagainst only 8% before seven years.

A cancer that is difficult to diagnose

the ovarian cancer generally only causes symptoms at an advanced stage of the disease and which may be associated with other pathologies (fatigue, bloating, abdominal pain or pelvic pain), ovarian cancer is deadliest gynecological cancer.

It is the origin of approximately 150,000 deaths every year worldwide, according to figures from the World Health Organization (WHO). In France, it affects approximately 4,400 women per year, of whom more than 3,000 die from it; 60% of women die of it within five years of diagnosis.

No organized screening exists to date, studies conducted in the past, particularly in Japan and the United States, having shown that systematic screening was useless.

The authors of the British study, for their part, insist on the need for longer-term follow-up and the implementation of more sensitive tests before being able to comment on the interest of screening in the general population.

In a comment attached to the study, Professor René Verheijen from the Netherlands welcomes the “encouraging results” of the British study, while questioning the fact that only 59% of cancers were detected by the screening put in place.

Source: “Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomized controlled trial”, The LAncet, December 17, 2015, DOI: -6736(15)01224-6

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