Ovarian cancer remains one of the most challenging cancers to diagnose and treat, and it has been dubbed the “silent killer” due to its subtle and often overlooked symptoms. High-grade serous ovarian cancer (HGSOC) is the most aggressive form, and contributes greatly to the high mortality rate associated with the disease. Recent research, however, brings a glimmer of hope, suggesting that earlier diagnosis could be possible through targeted testing and expedited specialist care, which could potentially improve survival outcomes for many women.
A comprehensive investigation, called The Refining Ovarian Cancer Test Accuracy Scores (ROCkeTS) study, was conducted across 24 hospitals in the UK. It provided crucial insights into the early diagnosis of ovarian cancer. The study revealed that up to 25% of women with HGSOC could have been diagnosed at an earlier stage, which would have significantly improved their prognosis. Given the current lack of a national screening program for ovarian cancer in the UK, these findings highlight the critical need for improved diagnostic strategies.
The Study and Its Findings
The ROCkeTS study analysed data from 1,741 patients who were fast-tracked for ovarian cancer testing due to the presence of symptoms such as bloating, bowel changes, and abdominal pain. Among these patients, 119 were diagnosed with high-grade serous ovarian cancer. Remarkably, over 25% of these women were diagnosed at stage 1 or 2 of the disease, where survival prospects are much better compared to later stages.
The importance of early diagnosis cannot be overstated. Of the women who were diagnosed at an early stage of the disease, 93% survived for more than five years. In stark contrast, only 13% of those diagnosed at more advanced stages achieved the same survival milestone. This huge difference in survival rates perfectly illustrates the life-saving potential of early detection.
The study also found that even when the cancer had spread, most patients required only “relatively straightforward” surgery. Specifically, 78 out of the 119 patients underwent debulking surgery to remove cancer cells from the abdomen. Another 36 women received chemotherapy before surgery, a common approach to shrink tumours and make surgery more effective. Notably, only five women did not undergo any surgical intervention, emphasising that the majority of patients, even at more advanced stages, could still benefit from surgical treatment.
The Current Diagnostic Approach and Its Limitations
Since 2011, the UK has relied on a symptom-based testing approach for ovarian cancer. This prioritises women who present with specific symptoms, such as bloating, bowel changes, and abdominal pain, for further testing. While this approach has improved the diagnosis of ovarian cancer in symptomatic women, it still falls short in identifying the disease at an early stage, particularly for those who may not exhibit symptoms until the cancer has progressed.
The challenge for health professionals in spotting ovarian cancer lies partly with its non-specific symptoms, which can easily be mistaken for less serious conditions. This often leads to delays in diagnosis, with many women only receiving a diagnosis when the disease has reached an advanced stage. The absence of a national screening program further exacerbates this issue, as there is no routine testing to catch the disease in its early, more treatable stages.
The Path Forward – Improving Early Diagnosis
The findings from the ROCkeTS study suggest that targeted testing and expedited specialist care could play a pivotal role in improving early diagnosis rates for HGSOC. By refining the criteria for fast-tracking patients and utilising advanced diagnostic tools, it may be possible to identify ovarian cancer earlier in a significant number of women.
One potential avenue for improvement is the development of more accurate and accessible diagnostic tests. Biomarker testing, for instance, could be used to identify women at higher risk of developing ovarian cancer, allowing for closer monitoring and earlier intervention. Additionally, increased awareness among healthcare providers and the public about the symptoms of ovarian cancer could lead to earlier testing and diagnosis.
Let’s Save More Lives
The ROCkeTS study has highlighted the critical importance of early diagnosis in ovarian cancer, particularly in high-grade serous ovarian cancer, the deadliest form of the disease. With around 7,500 new cases diagnosed every year in the UK, the potential to save lives through earlier detection is immense. This will, however, require a concerted effort to refine current diagnostic approaches, invest in new testing technologies, and perhaps most importantly, advocate for a national screening program that could detect ovarian cancer before symptoms even appear.
In the fight against ovarian cancer, time is of the essence. The earlier the diagnosis, the better the chances of survival. The ROCkeTS study offers a roadmap for achieving this goal, but it is up to healthcare systems, researchers, and policymakers to turn these insights into action. The lives of thousands of women depend on it.
