- Early detection of ovarian cancer
- Our laboratory has been dedicated to developing an effective screening strategy for early stage of ovarian cancer. Having discovered CA125, we have collaborated with Drs. Karen Lu and Steven Skates to develop a two-stage strategy where rising CA125 analyzed by the risk of ovarian cancer algorithm (ROCA) triggers transvaginal sonography (TVS) in a small fraction of postmenopausal women at average risk for developing ovarian cancer, the NROSS study. If TVS identifies a pelvic mass, surgery is undertaken. More than 35,000 annual blood specimens have been obtained from >6,800 women over the last 19 years. Less than 2% of participants have undergone TVS each year, prompting 24 operations and detecting 15 cases of ovarian cancer - two borderline and 15 invasive - with 10 (67%) in stage I or II. No more than 3 operations were required to detect each case of ovarian cancer. Similar specificity has been observed in a United Kingdom trial (UKCTOCS). While the UKCTOCS demonstrated a 20% improvement in mortality, confidence limits around this estimate are large and additional observation is needed to validate this estimate. To detect cases missed by CA125, we have evaluated >110 biomarkers to identify a panel that includes CA125, HE4, and CA72-4 . Statistical techniques are being developed that will permit use of multiple markers to improve sensitivity without sacrificing specificity. Nearly 5,000 women continue to participate in the NROSS screening study. A new algorithm is being developed that will be evaluated in this population.
To update protocols, publications, biomarkers, or science data, please contact the
Data Management and Coordinating Center.