Background
Ovarian cancer was responsible for 4560 deaths in 2000 in the UK. Of the 5960 new cases, approximately 10% are attributable to an inherited predisposition. Women at high risk can be identified from their family histories and in some cases by testing for mutations of the BRCA1 and BRCA2 genes. The only prevention strategy available is prophylactic surgery, which can result in significant morbidity and consequently, many women opt for screening, even though its efficacy is unproven. Relevance to cancer
An optimised screening strategy is required for women at high risk of ovarian cancer.
Specific aims of the research
- To develop an optimised screening procedure for ovarian cancer in high-risk women.
- To determine the physical morbidity, resource implications and feasibility of screening this high-risk population.
- To establish a serum bank for future assessment of novel tumour markers.
Outline plan of research
Women will be screened annually with transvaginal ultrasound and every four months with the serum tumour marker CA125. CA125 levels will be processed by a Risk of Ovarian Cancer Algorithm (ROCA), which stratifies women according to their pattern of CA125 over time. Women with intermediate ROCA results will have a repeat ultrasound. Women with suspicious scans or highly elevated ROCA results will be referred to a gynaecological oncologist for consideration of surgical investigation.
