Advanced blood test could detect early ovarian cancer: trial

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An advanced blood test is set to be offered to patients experiencing ovarian cancer symptoms at a few select health-care facilities in the U.K., in a new trial that researchers hope could revolutionize the way we diagnose this dangerous disease.

The test is called ROMA, which stands for Risk of Ovarian Malignancy Algorithm, and researchers say it can diagnose more cases of ovarian cancer at earlier stages than existing tests.

In order to give it a real-life test run, a trial is being launched in the U.K. communities of Walsall, Sandwell and Birmingham for 18 months. The project is being run by Sandwell and West Birmingham NHS Trust and Walshall Healthcare NHS Trust, in partnership with the University of Birmingham and primary care provider Modality.

“Our aspiration is to transform the care of ovarian cancer by earlier detection and better outcomes for our patients,” Dr. Aamena Salar, medical director for Modality Partnership Community Services, said in a press release.

If a patient who is offered this test is found to be positive for key markers of the disease, they will be referred to a specialist and then undergo further treatment.

“With Modality-run GP surgeries trialling the ROMA test we will be able to establish if it is acceptable to patients and clinicians,” Sudha Sundar, a professor at the University of Birmingham and consultant in gynecological cancer surgery at SWB NHS Trust, said in the release.

“By testing many samples across two large laboratories we will be able to confirm whether the ROMA test has a higher chance of detecting this cancer earlier than the current CA-125 blood test used and whether implementing this across the NHS will be cost-effective.”

The chances of surviving ovarian cancer are better the earlier the disease is diagnosed. According to the Canadian Cancer Society, the five-year survival rate for ovarian cancer is 45 per cent in Canada, but that survival rate ranges widely depending on the stage and type of ovarian cancer. The five-year survival rate for stage four epithelial ovarian cancer, for instance, is only 17 per cent in Canada.

Similar survival rates are seen globally.

“We know that 90 per cent of women diagnosed with ovarian cancer at Stage 1 will survive, but this drops drastically to 15 per cent if it is picked up during Stage 4,” Sundar said.

Symptoms for ovarian cancer include bloating, stomach pain, needing to urinate more often and always feeling full. Additional symptoms can be abnormal vaginal bleeding, frequent discharge that is coloured differently than usual, a lump in the pelvis or abdomen or a buildup of fluid (ascites) in the abdomen, chest or legs, among other symptoms.

Because the earliest symptoms of ovarian cancer tend to be ones that could be dismissed as connected to other issues, ovarian cancer is frequently not diagnosed until a later stage.

When symptoms are persistent, the standard process is to receive an ultrasound or a CA-125 blood test. This existing blood test focuses on a biomarker for ovarian cancer, which is the elevated presence of a protein called Cancer Antigen 125 in the blood. But although this protein is elevated in 80 per cent of women with advanced ovarian cancers, it is only elevated in 50 per cent of those with early-stage ovarian cancer, meaning many early cases aren’t detected with this test.

The new ROMA blood test is more sensitive than the CA-125 blood test, researchers say — something they’re hoping this trial will prove.

“Research conducted with my team at the University of Birmingham found out that the ROMA test is significantly better than current tests (CA-125 and ultrasound) used in both pre- and postmenopausal women,” Sundar said.

“Whilst a previous study had found that the ROMA test detects up to 20 per cent more early-stage cancers than the current test which only picks up 50 per cent of early-stage cancers. We are putting this research into practice by carrying out this trial.”

The trial will be funded by the NHS Cancer Programme and the Small Business Research Initiative. At the end of it, 41,000 samples will be analyzed in laboratories to determine whether the ROMA test truly was accurate and cost-effective enough to be implemented at scale by the NHS.

“It’s an exciting study which is a great example of integrated working between all the organizations involved,” Sundar said. “We are looking forward to finding out the results so that we can change the way this cancer is detected in the future and drastically improve survival rates.”