The ROCA Test is intended for women who are between 50 and 85 years old and have been through menopause, or between 35 and 85 years old with a family history of ovarian and/or breast cancer, are of Ashkenazi Jewish descent with a known family history of ovarian or breast cancer, or have tested positive for BRCA1, BRCA2 or Lynch syndrome gene mutation.
In February 2017, the Journal of Clinical Oncology published a landmark paper detailing the results of a trial involving over 4,000 women with a one in 10 or greater lifetime risk of developing ovarian cancer. The women took part in the multi-year trial after declining risk reducing surgery to remove their fallopian tubes and ovaries. The women were screened with a blood test for the tumour marker CA125 every four months and an ultrasound scan of their pelvis once a year. The blood test results were analysed by ROCA to calculate the risk of having ovarian cancer at that time. Women over a certain risk level were referred to a gynaecologist for further assessment.
Screening was estimated to have detected over 9 out of 10 cancers before they caused symptoms. Women on the screening program were significantly less likely to be diagnosed with the most advanced stages of ovarian cancer compared with those who were no longer being screened on the program. In addition, over 90% of women diagnosed during the screening phase had all their tumours removed at the time of surgery. This is known to be very important in terms of predicting long-term survival. Finally, these women did not require complex surgery to remove all their tumours. However, the study was not able to show whether the screening increased the time women survived their cancer.
In summary, for women not yet willing to undergo risk-reducing surgery, the screening programme developed by UK FOCSS appears to offer the best chance of avoiding being diagnosed with a very advanced cancer. Therefore, screening along with continued discussions about the need for risk-reducing surgery is an option for such women.
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