Long-term screening study shows promising predictive tool for ovarian cancer

The Normal Risk Ovarian Screening Study (NROSS) is a two-phase screening strategy for postmenopausal women who are considered at normal risk for ovarian cancer. The first phase uses a cancer antigen 125 (CA125) blood test and a Risk of Ovarian Cancer Algorithm (ROCA) to determine whether the second phase, a transvaginal sonography, is needed. Patients with an abnormal transvaginal sonogram would then be referred for surgery. A new analysis published by Robert Bast, M.D., Karen Lu, M.D., and colleagues shares NROSS results from the last two decades, including 7,856 women and 50,596 woman-years. A total of 34 patients received surgery: 15 with confirmed ovarian cancers, two with borderline early-stage ovarian tumors, seven with endometrial tumors and one with lung cancer. While the NROSS did not have a control arm like a similar UKCTOCS trial, 70% of ovarian cancers and borderline tumors detected were early stage (stage I-II), and the strategy had a positive predictive value of 50% for detecting ovarian cancer and 74% for detecting any cancer. The screening approach also reduced late-stage disease by 34% for ovarian cancer and by 30% for any cancer compared to the UKCTOCS and U.S. Surveillance, Epidemiology, and End Results (SEER) Program values. These results support further development of the NROSS strategy to improve patient outcomes.