Why is it important to screen for ovarian cancer?
Ovarian cancer is the leading cause of death among gynecological malignancies in the United States. Early ovarian cancers often do not demonstrate visible symptoms. When it comes to ovarian cancer, most of the noticeable symptoms begin only when the disease has progressed to an advanced stage.
Basis of Screening:
Survival of ovarian cancer depends on the stage at the time of diagnosis. The 5-year survival rate is more than 90% in some patients with stage 1 ovarian cancer, whereas it drops to 25% in patients with stage IV ovarian cancer. Despite an excellent prognosis with early-stage disease, the overall 5-year survival is less than 45% because of the spread of cancer beyond ovaries in the majority of the patients. Hence, early detection with screening can improve the mortality rate and overall survival.
Women at an increased risk of developing ovarian cancer, such as those who have a family history of cancer should consider getting screened regularly. Screening in the absence of symptoms is essential to eliminate the possibility of cancer in candidates who are at high-risk. Besides, early detection, treatment is more effective.
What are the different screening systems available for ovarian cancer?
The different types of tests, processes, and infrastructure used to screen for ovarian cancer are as follows:
Transvaginal Ultrasound (TVS)
The transvaginal ultrasound is a device that uses sound waves to look at the ovary, fallopian tubes, and the uterus by inserting an ultrasound wand into the vagina. Consequently, this type of testing identifies a mass or tumor in the ovary. However, it cannot determine if the mass is cancerous or benign. Studies have shown that most masses found through this type of testing are not malignant.
CA-125 blood test
The CA-125 test is a blood test measures the levels of the protein CA-125 in the blood. Most women with ovarian cancer present with high levels of CA-125 in their blood. CA-125 increases in 50% of patients with early ovarian cancer and 80% of patients with advanced disease.
The main disadvantage of this tumor marker is that its specificity is inadequate. It is raised in other conditions apart from ovarian cancer. These conditions are endometriosis, uterine leiomyosarcoma, pelvic inflammatory disease, cancers of breast, endometrium, lung, and pancreas.
Risk of ovarian cancer algorithm (ROCA)
ROCA screening is a statistical tool to check the risk of developing ovarian cancers depending on a woman’s age and changes in the levels of the protein CA-125 over some time. The ROCA test is also sensitive enough to rule out the possibility of ovarian cancer at its earliest stages (Stages 1 and 2).
Screening tests for germ cell tumors and stromal tumors
Germ cell tumors or stromal tumors do not come with a set of screening tests. But the most common protein markers seen in germ cell tumors are human chorionic gonadotropin (HCG) and alpha-fetoprotein. These protein markers are spotted through a simple blood test. After the detection of markers of germ cell tumors or stromal tumors, surgery or chemotherapy are usual recommendations. Furthermore, doctors recommend a blood test to check if a patient’s cancer is recurring, or if a patient’s ongoing treatment is effective.