Can ovarian cancer screening work? A secondary analysis of the UK collaborative trial of ovarian cancer screening

Rákkutatás · Ovarian cancer

Current screening modalities offer a very limited opportunity to intercept high‑grade serous ovarian cancer (HGSC) at an early stage.

The UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS; 2001–2020) showed no reduction in disease mortality in its primary intervention arm using multimodal screening (MMS) with longitudinal Cancer Antigen 125 (CA125) and transvaginal ultrasound. Using individual‑level screening and diagnosis data from the MMS arm, we estimated ovarian cancer natural history, focusing on high‑grade serous ovarian cancer (HGSC), the most common and lethal subtype. We then simulated trial outcomes under (1) continued screening beyond the trial screening interval and (2) high sensitivity for early‑stage detection over an extended time period. The estimated window for detecting early‑stage HGSC under MMS was <6 months. Continued screening yielded at most a 15% relative mortality reduction. Achieving a >20% mortality reduction required extending the detectable early‑stage window to 1 year and attaining >70% sensitivity during this period. Current screening modalities offer a very limited opportunity to intercept HGSC at an early stage. Clinically effective ovarian cancer screening will require first‑ and second‑line tests capable of detecting HGSC substantially earlier in its natural history.

Early detection of ovarian cancer, particularly HGSC, is associated with markedly improved survival, yet the UKCTOCS trial demonstrated that current CA125‑based screening offers a very narrow window for early detection and thus limited mortality benefit. This underscores the need for more sensitive and earlier‑detecting screening modalities to change outcomes for patients.

Bizonyítékszint: Korai humán adat. Kis vagy feltáró emberi adat.

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