Expect Questions About Ovarian Cancer Screening

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The authors of an ovarian cancer screening study published in The Lancet1 and many of the experts commenting on the study in the media agree that the results of multimodal screening are encouraging and could reduce mortality from ovarian cancer, but further follow-up is needed. Considering that the U.S. Preventive Services Task Force recommends against routine screening of women at average risk of ovarian cancer, what can patients who may have heard or read about the study and are concerned about testing for ovarian cancer do in the meantime?

“We would recommend that they participate in an ovarian cancer screening study,” said Karen Lu, MD, Chair of the Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, at The University of Texas MD Anderson Cancer Center, Houston, in an interview with The ASCO Post.

Ongoing Study

Dr. Lu is also lead investigator of a multicenter ovarian cancer screening study that uses the same Risk of Ovarian Cancer Algorithm (ROCA) used in the study reported in The Lancet.

Based on a patient’s age and CA-125 score, study participants are triaged to one of three risk groups: low-risk women, who receive annual CA-125 screening; intermediate-risk women, who have repeat CA-125 tests in 3 months; and high-risk women, who receive repeat CA-125 and transvaginal ultrasound and are referred to a gynecologic oncologist. Preliminary data from that study were first presented at the 2010 ASCO Annual Meeting, and updated findings were published in Cancer.2

The multicenter study involves seven sites across the country. Dr. Lu noted that screening studies have been conducted at other institutions as well, including the Fred Hutchinson Cancer Research Center in Seattle.

While the algorithm used in the MD Anderson study is based on CA-125 testing, Dr. Lu stressed that women should be cautious about independently pursuing CA-125 testing. “Even going from two different labs, you can also have variations in CA-125,” Dr. Lu said. In addition, “some women naturally have a higher CA-125.” ■

Disclosure: Dr. Lu reported no potential conflicts of interest.


1. Jacobs IJ, Menon U, Ryan A, et al: Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): A randomised controlled trial. Lancet. December 17, 2015 (early release online).

2. Lu KH, Skates A, Hernandez MA, et al: A 2-stage ovarian cancer screening strategy using the Risk of Ovarian Cancer Algorithm (ROCA) identifies early-stage incident cancers and demonstrates high positive predictive value. Cancer 119:3454-3461, 2013.