The use of a new algorithm for ovarian cancer surveillance in women at raised genetic risk can help delay preventive surgery, researchers report today.
Women are often keen to delay the procedure as they cause infertility and premature menopause. So Dr Adam Rosenthal of University College London, UK, and colleagues explored the safest approach to delaying surgery.
In yesterday’s Journal of Medical Genetics they explain: "Our study aimed to establish ’real-world’ performance and cost-effectiveness of ovarian cancer surveillance in women with pathogenic germline BRCA1/2 variants who defer risk-reducing bilateral salpingo-oophorectomy."
Their ‘Risk of Ovarian Cancer Algorithm’ (ROCA) test calculates the probability of ovarian and fallopian tube cancer by assessing the rate of change in the blood protein CA125.
It was tested on 767 women who had at least one four-monthly assessment, and who were monitored accordingly. The accuracy of the test at highlighting cancer was 87%, and the accuracy of ruling out those without cancer was just under 100%.
The authors report that these real-world results are comparable to those found in clinical trials of the algorithm.
They conclude that this approach is feasible and "cost-saving in the UK NHS setting". They point out that surgery is recommended but this type of surveillance may be considered for women who are deferring surgery.
Philpott, S. et al. The avoiding late diagnosis of ovarian cancer (ALDO) project; a pilot national surveillance programme for women with pathogenic germline variants in BRCA1 and BRCA2. Journal of Medical Genetics 2 November 2022; doi: 10.1136/jmg-2022-108741
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