26th November 2014
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New test for ovarian cancer

A new test, called ADNEX, reported in the British Medical Journal in October 2014 helps to identify different types and stages of ovarian cancer more accurately, which scientists claim will reduce the incidences of unnecessary surgeries. 
 
Accurate, simple and ready
The test, developed by an international team led by Imperial College London and KU Leuven, Belgium, is based on patient data, a simple blood test, and features that can be identified on an ultrasound scan. Doctors can use it simply by entering patient data into a smartphone app. It’s highly accurate, and discriminates between benign and malignant tumours, and also identifies different types of malignant tumours.
 
Successful treatment depends on accurate diagnosis, and diagnosis of ovarian cancer can be challenging. According to Professor Tom Bourne, Department of Surgery and Cancer at Imperial College London, "The way we assess women with ovarian cysts for the presence of cancer and select treatment lacks accuracy. This new approach to classifying ovarian tumours can help doctors make the right management decisions, which will improve the outcome for women with cancer. It will also reduce the likelihood of women with all types of cysts having excessive or unnecessary treatment that may impact on their fertility.
Frequently misdiagnosed
The frequent misdiagnosis of ovarian cancer means that it often presents late when it has already metastasized. It’s the most aggressive gynecological malady, with poor survival rates: only 40% survive beyond five years, and it can affect any woman.
 
The reason why early symptoms are difficult to detect is because inside the abdomen, the ovary has a lot of space to grow into before it starts to press onto other structures such as the uterus, bowel and bladder.
 
Early detection is key
All women should be on guard of the symptoms, which may be vague at first, and similar to other conditions, such as digestive disorders. The commonest symptoms are discomfort or pain in the lower abdomen or pelvis, and also there may be backache or a swelling felt.
 
There is a survival rate of up to 90% when ovarian cancer is caught early, compared with less than 30% if it is discovered in the later stages. See, Cancer survival and patient centred healthcare (click below).

Increasing incidence in younger women
Around 1 in 55 women will get ovarian cancer at some time in their life, and it is more common over the age of 40. Less than 1 in 20 ovary cancers occur in women younger than this. There are inherited factors involved in some cases, and research is underway to find out how best to screen women at increased risk of the disease. Since the mid-1970s, the incidence of ovarian cancer in women between 15 and 39 has increased by some 56%.
 
Takeaway
Currently, early detection, and rapid referral to a specialist gynaecological cancer unit is the key to transforming survival rates for ovarian cancer. Patients therefore have to rely on seeing a doctor, and being correctly diagnosed in time. 
 
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Hani Gabra
Professor of Medical Oncology and Deputy Head of the Division of Cancer at Imperial College, London; President, EUTROC
Why is ovarian cancer often diagnosed late?
What is the future of ovarian cancer treatment?
Whitfield Growden
Gynecologic oncologists, Harvard University Medical School and the Massachusetts General Hospital, USA   
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Christina Fotopoulou
Professor of Surgery, Imperial College, London
How do you determine the extent of surgery that is required for someone with ovarian cancer?
To what extent has ovarian cancer become a chronic disease, which patients can live with?
David Bowtell
Head of Cancer Genomics and Genetics, MacCallum Cancer Centre, Melbourne, Australia
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