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Symptoms Plus Blood Test Boost Ovarian Cancer Detection

The combo uncovered 80% of early-stage tumors, researchers say,,

MONDAY, June 23 (HealthDay News) -- U.S. researchers boosted the level of early-stage ovarian cancer detection by 20 percent through use of a blood test to detect a tumor marker as well as a woman's report of new-onset symptoms.

Using either test alone only uncovered about 60 percent of early-stage ovarian cancers in a high-risk group of women, while the two techniques together found 80 percent of early-stage tumors, according to finding published Monday in the online version of the journal Cancer.

"They appear to act complementary, and appear to be able to identify women who would not be identified by a blood sample alone, and conversely would not be identified by symptoms alone," said the study's lead author, M. Robyn Andersen, an associate member of the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center in Seattle.

More than 21,000 women are diagnosed with ovarian cancer annually, and more than 15,000 women die from the disease each year, according to the American Cancer Society (ACS). Currently, only about 20 percent of ovarian cancers are caught in their earliest, potentially curable stages, according to Andersen.

In 2006, Andersen's colleague, Dr. Barbara Goff, director of gynecologic oncology at the University of Washington School of Medicine, published the ovarian cancer symptom-screening index tool, in an effort to help women and doctors clarify which women might have a heightened risk of ovarian cancer.

Important symptoms include pelvic or abdominal pain, bloating, increased abdominal size, difficulty eating, or feeling full quickly. These symptoms must occur more than 12 times per month, and have just recently begun occurring (within the past year), to be considered positive on the symptom-screening tool. For example, if a woman has had abdominal pain for the past 10 years, it's probably not related to ovarian cancer, but to another disorder, such as irritable bowel syndrome.

For the current study, Andersen and her colleagues used the symptom-screening index and a blood test that looks for CA 125, a protein that is often elevated in ovarian cancer. However, CA 125 can sometimes be elevated in women who don't have ovarian cancer, the researchers noted.

The study involved 254 healthy women at high-risk for ovarian cancer because of family history, as well as 75 women about to undergo surgery to remove an ovarian cancer. The women were asked to fill out a questionnaire about their symptoms. All of the women also gave a blood sample to have their levels of CA 125 measured.

The two methods together correctly identified almost 90 percent of the ovarian cancers -- 80.6 percent of the early cancers and 95.1 percent of the later-stage cancers.

About 14 percent of women who had symptoms and had elevated levels of CA 125 did not have ovarian cancer, according to Andersen. These women received transvaginal ultrasound tests for follow-up, according to Andersen.

"This study continues to add on to the work that's been done, but we still have a long way to go with ovarian cancer," commented Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

None of the current screening tools is as accurate as the ACS and other experts would like them to be, she explained. Any of the tests alone misses a significant number of cancers, and unnecessarily worries women who don't have cancer. Saslow said transvaginal ultrasound can be a good test, but it has to be done by an experienced sonographer, and there are no current guidelines to define how much experience is enough.

Additionally, Saslow said that no research has been done to prove that early detection saves lives.

Andersen said the researchers recommend that if you have any of the symptoms of ovarian cancer, and they're new-onset symptoms, that you should discuss them with your doctor. But, she added that, "even with this specific pattern of symptoms, most women probably don't have ovarian cancer, just as most women with a breast lump don't have breast cancer."

More information

To read more about ovarian cancer detection, visit the American Cancer Society.

SOURCES: M. Robyn Andersen, Ph.D., associate member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Wash.; Debbie Saslow, Ph.D., director, breast and gynecologic cancer, American Cancer Society; June 23, 2008, Cancer online

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