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Ovatools

Tests and tools for the detection of ovarian cancer in primary care

The Ovastools project consists of three studies which utilise routinely collected primary care and cancer registry data to evaluate existing ovarian cancer tests and to develop novel diagnostic tools. Studies include:

1) An evaluation of the diagnostic performance of the CA125 tumour marker in primary care

This study evaluated the performance of CA125 in over 50,000 women who had the test performed in English primary care. The study found that the proportion of women with an abnormal test and ovarian cancer was more than 12 times higher previously thought and that a significant proportion of women with high CA125 levels had a cancer other than ovarian. Simple models where developed which will enable women their doctors to determine the estimated risk of cancer based on their individual CA125 level and age – this should help them to make informed decisions on the need for further investigation. The results were recently published in PLOS Medicine and are further discussed in a CRUK blog post.

2) The association between CA125 results and timely ovarian cancer diagnosis

While CA125 is a useful test for ovarian cancer, some women have a normal result prior to diagnosis. This study seeks to explore the impact of these ‘false-negative’ test results on the time taken for patients to be diagnosed with ovarian cancer and the cancer stage at diagnosis.

3) The development and validation of a multivariable primary care model for ovarian cancer detection

This study seeks to develop and validate a novel multivariable model – incorporating blood tests, patient demographics and symptoms – for use in primary care to guide decisions on the need for specialist referral for possible ovarian cancer.

Ovarian cancer diagnostic guidelines

A systematic review of international guidelines on the initial assessment for ovarian cancer

The review included 18 guidelines from 11 countries and identified marked differences in the way women with possible ovarian cancer are assessed and investigated in countries around the world. This variation could contribute to differences in early ovarian cancer detection rates between countries and highlights the need for greater research to evaluate and compare diagnostic approaches for ovarian cancer in primary care.

Tools for ovarian cancer detection

Identifying ovarian cancer in symptomatic women: a systematic review

This review identified 21 tools developed to help select women with symptoms of possible ovarian cancer for further investigation. Of these, we identified four tools evaluated in multiple datasets which showed reasonable accuracy. These tools could be useful in ovarian cancer detection, but their impact on the timely detection of ovarian cancer and on patient survival needs to be evaluated. This study is further discussed in a CanTest blog post.

For more information on all the above please contact: Garth Funston