Avoiding late diagnosis of ovarian cancer 

11/03/2019 00:00 

UCLH Cancer Collaborative recently launched the first pilot project of an NHS ovarian cancer surveillance service for women who carry a faulty BRCA gene and have chosen not to have their ovaries and fallopian tubes removed.

The pilot, known as the ALDO project (Avoiding Late Diagnosis in Ovarian Cancer), aims to recruit 2,000 women aged over 35 from across England and will use Abcodia’s ROCA© Test as part of an NHS service to detect ovarian cancer amongst BRCA-carriers before they have any symptoms.

The ROCA Test uses an algorithm to assess changes in the level of the blood chemical CA125, which typically rises in ovarian cancer. Participants will have the ROCA Test every four months. This is the first time that this technology has been piloted as an NHS service and heralds a significant step towards meeting recommendations in the National Cancer Strategy to improve early diagnosis.

The aim is to confirm the feasibility and cost-effectiveness of introducing ovarian cancer surveillance for women with a faulty BRCA gene across the NHS as standard practice. Every year, more than 7,000 women are diagnosed with ovarian cancer and over 4,000 women die from the disease.

Ovarian cancer is often diagnosed late, as symptoms are hard to spot. Only 35 per cent of women will live for 10 or more years after diagnosis, largely due to late detection. Inherited faults in the BRCA1 or BRCA2 genes dramatically increase women’s chances of developing breast and ovarian cancer.

For ovarian cancer, the chances of developing the disease increase from around two per cent in the general population to 40-60 per cent in BRCA1 carriers, and 10-30 per cent amongst BRCA2 carriers. It is estimated that approximately one in 400 women have a faulty BRCA gene.

Women who are at high risk face a difficult decision – either they wait and see what happens or they take preventative measures (removal of both their ovaries and fallopian tubes). While this is the most effective way of preventing ovarian cancer, it can also have major side-effects, particularly for pre-menopausal women, including infertility and premature menopause.

Unlike the situation with breast cancer risk, there is currently no NHS ovarian cancer surveillance for these women and no national guidance, apart from having surgery. The ALDO project was conceived in 2017 as part of the national Cancer Vanguard’s challenge to industry, aiming to identify opportunities for NHS and industry collaboration that could help to improve the early diagnosis of cancer.

It is supported by Cancer Research UK, The Eve Appeal, Ovarian Cancer Action, OvaCome and Target Ovarian Cancer.

Further information on the ALDO project can be found here: www.uclh.nhs.uk/ALDO

If your patients would like to take part in the project, the project team can be contacted on uclh.ALDO@nhs.net.

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