Ovarian cancer screening did not reduce mortality during the study

The results of the UK CTOCS for ovarian cancer screening are published in the report of the medical journal The Lancet.
In the UK, 4,000 women die of ovarian cancer each year. It is usually not diagnosed until it is late and difficult to treat. UKCTOCS was designed to test the hypothesis that reliable screening methods for early detection of ovarian cancer can save lives when treatment is likely to be effective.
The latest analysis looked at data from more than 200,000 women aged 50-74 years at hire, who were followed for an average of 16 years. Women were randomly assigned to one of three groups: no screening, annual screening using ultrasound scans, and annual multimodal screening including blood tests followed by ultrasound scans as a secondary test. It was.
Researchers have found that the multimodal test approach succeeded in detecting cancer early, but neither screening method led to a reduction in mortality.
Previous detections at UKCTOCS did not save lives. Researchers said this emphasized the importance of seeking evidence that potential screening tests for ovarian cancer actually reduced mortality and detected cancer early.
Professor Usha Menon, UCL’s MRC Clinical Trials Unit, a senior researcher at UKTOCS, said: Neither approach we have tested has saved lives, so it is not advisable to use these methods to screen the general public for ovarian cancer.
“We are disappointed because this is not the result of many years of wanting and working for us and everyone involved in the exam. To save lives, faster and more women than multimodal. Need better screening tests to detect ovarian cancer in. The screening strategy we used. “
Women between the ages of 50 and 74 were enrolled in the 2001-2005 exam. Screening continued until 2011 and was either an annual blood test, monitoring of changes in protein CA125 levels, or an annual vaginal ultrasound scan. Approximately 100,000 women were assigned to unscreened groups and more than 50,000 women were assigned to each screening group.
Blood test screening detected 39% more cancer in the early stages (stage I / II) and 10% less in late stage cancer (stage III / IV) than in the unscreened group. There was no difference in the stage of cancer detected in the ultrasound group compared to the unscreened group.
The first analysis of mortality in the trial was done in 2015, but at that time there were not enough data to conclude whether screening reduced mortality. Looking at the additional five years of follow-up data from the women involved, researchers can conclude that screening did not save lives.
Professor Mahesh Parmar, director of the UCL’s MRC clinical trials unit and lead author of the treatise, said: The screening was not effective for women without symptoms of ovarian cancer. In symptomatic women, the combination of early diagnosis and this better treatment may make a difference in quality of life and improve outcomes. In addition, prompt diagnosis, regardless of the stage of the cancer, is very important for women and their families. “
Professor Ian Jacobs of the University of New South Wales (UNSW Sydney) has led the Ovarian Cancer Screening Research Program since 1985 and was a senior researcher at UKCTOCS from 2001 to 2014. Stated. Thousands of women, medical professionals and researchers who made this exam possible. Multimodal screening strategies succeeded in detecting ovarian cancer early on, but unfortunately it did not save lives. Each year, everyone was involved in saving the lives of thousands of women suffering from ovarian cancer. “
Professor Jacobs said: “Ovarian cancer mass screening is only supported if future randomized controlled trials show that it will reduce mortality. We hope that new and effective screening will eventually be found, but the test In reality, this means that we need to reluctantly accept that mass screening for ovarian cancer is more than 10 years away. “
A huge amount of samples and data from the trials were donated by participants for future research. This resource, called the UKCTOCS Longitudinal Women’s Cohort (UKLWC), is currently being used by researchers around the world to better understand not only ovarian cancer, but other cancers and other diseases such as cardiovascular disease. It is useful for.
The researchers also say the study also provided insight into the best ways to design, conduct, and analyze large-scale randomized clinical trials, especially in individuals who have no signs of illness. These insights will help future trials in all areas of health. It also contributes to advances in ovarian cancer risk assessment, prevention and diagnosis.
The UKCTOCS exam was funded by the NIHR Health Technology Assessment (HTA) program and the charities Cancer Research UK and The Eve Appeal.
Michelle Mitchell, Chief Executive Officer of Cancer Research UK, said: Study aggressive forms of ovarian cancer so that the effects of this disease can be reduced.
“Since screening is aimed at asymptomatic people, it is important to consult a doctor if you notice any abnormalities or persistent changes. The symptoms of ovarian cancer are very vague and less serious. It is tricky, which can be similar to the symptoms caused by and can lead to the discovery of the illness. Do you need to go to the toilet more often, or are you in pain, bloating, or something else? Regardless, raise it in the GP-in most cases it’s not cancer, but it’s best to check it. “
Professor Nick Lemoin, Medical Director of the NIHR Clinical Research Network, said: “These important findings from a large trial involving 200,000 participants show that annual screening did not succeed in reducing ovarian cancer mortality.
“But it is important to note that negative results can be as important as positive results. This study conducted a large future randomized clinical trial for ovarian cancer and It provided important new evidence and insights on how to analyze it. In the future, it will more effectively diagnose the disease.
“Thanks to everyone who participated.”
Athena Lamnisos, CEO of The Eve Appeal, said: “The threshold for introducing a national cancer screening program is the benefit of mortality. Of course, this is important. It is life-saving. This research program is nationwide for ovarian cancer and the like. Although not recommended as a screening program, its impact on early diagnosis is impressive and important.
“Ovarian cancer is often diagnosed in stage 3 or 4, and shifting the diagnosis one stage earlier makes a big difference in both treatment options and quality of life. Early diagnosis is the quantity and intensity of treatment. Often lowers and makes all the difference to women, and their families live with cancer, which may also have given them more valuable time with their loved ones. ” (ANI)