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Do you need this ovarian cancer test?

December 23, 2018

 

Ovarian cancer is very deadly. Almost 3/4 women ever diagnosed has advance disease which has a 5 year survival rate of only 20%. But like other diseases if we can diagnose early , the survival rate is almost 90%. Any testing that helps that diagnosis is viewed by all women as very important.

 

We cannot just test every woman, so we have to decide who needs an ovarian cancer test.

 

Women and their providers are warned that ovarian cancer screening is not simple, not very accurate yet, and should never replace continued vigilance with respect to symptoms. Ovarian cancer is the quiet cancer: subtle signs are often present and can bring a case to detection.

 

Women who have screening for ovarian cancer are warned by the FDA that there are some tests with false claims and the tests should not be overly interpreted. At Women's Health Practice we want our patients to know that there are ways to prevent ovarian cancer, and for those at risk, we encourage medical discussion to see if in fact you are doing all you can to prevent ovarian cancer. There are still women who can benefit by screening, and evaluating your screening process as new information becomes available is important.

 

Abbott Diagnostics and Fujirebio Diagnostics, did  FDA: clearance of their blood test for ovarian cancer. The test, is to detect extremely small particles from the blood stream that may have been shed from the surface of an ovary, and more likely from an ovary with an ovarian cancer. This new test is testing for Architect human epididymis protein 4 [HE4].

 

CA125 testing, with pelvic ultrasound, and a pelvic exam are the best tests for ovarina cancer. Only 8 of 10 ovarian cancers express CA 125. More are thought to express HE4, so this new test has possible potential to improve screening some day.

 

We no longer think that women who previously underwent fertility treatment should be more intensely screened for ovarian cancer than just her yearly pap smears. One study done Whittemore and researchers reported in the American Journal of Epidemiology that there was an association of ovulation inducing medications and ovarian cancer. This has then been looked at again, but follow up of these women has been difficult. Even though some studies followed women for up to 15 years, that still left the women far younger than many women who get ovarian cancer. There was slight risk, but most risk would be countered by getting pregnant or using birth control pills and thus the magnitude of risk is still thought to be so slight that just getting the normal screening in a low risk patient (pap smears and pelvic exams). For those with family history more may be indicated. 

 

Anything we can do to try to find ovarian cancers when they are at the earliest stages is extremely important. The survival rate of women with early stage ovarian cancer is over 95%, so you have both a better chance of survival and a better chance of keeping your ovaries when you do get treated in an earlier stage.

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