Surveillance for Ovarian Cancer
The ROCA Test helps clinicians identify whether a woman may have ovarian cancer.
The ROCA Test is for women who are between 35 and 85 years who have a high risk of developing ovarian cancer due to a mutation in the BRCA1 or BRCA2 genes
The ROCA Test is not yet available through the NHS.
Any clinician wanting to offer the ROCA Test as part of their private consultations should also contact us by Email at firstname.lastname@example.org
Abcodia is working in partnership with the NHS in a implementation project for women at high risk of ovarian cancer, and specifically those who carry a genetic mutation in one of the two BRCA genes. This project is called ALDO (Avoiding later Diagnosis of Ovarian cancer) the results from which will be published soon.
Performance of the ROCA Test as reported in UKFOCSS
The UK Familial Ovarian Cancer Surveillance Study (UKFOCSS) was a 10-year clinical trial, involving over 4,300 women at an estimated >10% lifetime risk of developing ovarian cancer. All women participating in this study received multimodal surveillance (MMS, ROCA Test followed by transvaginal ultrasound) every 4 months, in addition to an annual ultrasound if ROCA remained normal. At the time of recruitment, women were asymptomatic women between 35 and 85 years old.5
These results, published in the Journal of Clinical Oncology, showed:
- A highly significant reduction in the proportion of women being diagnosed with macroscopic metastatic disease outside the pelvis (from 95% to 37%).
- A significantly lower proportion of women requiring neoadjuvant chemotherapy (5% vs. 44%).
- A very high proportion (95%) with zero residual disease post-surgery, despite the lower use of neo-adjuvant chemotherapy. Zero residual disease status is one of the strongest predictors of prognosis in ovarian cancer.
- Only 21% of women undergoing surgery required anything more than a simple hysterectomy and omentectomy, compared with clinically presenting cases, where surgery is usually more complex and frequently involves other procedures such as bowel resection.
In a parallel US publication6 (including a smaller number of incident cancers), although it included a smaller number of incident cancers, demonstrated similarly encouraging earlier stage diagnosis. Qualitative data7from the UK cohort suggests that surveillance itself may prompt women to focus on their risk of cancer and push them towards the risk-reducing surgery which they need. Therefore, another important secondary benefit of surveillance may be that it encourages uptake of a proven cancer prevention strategy.
- Rosenthal AN, Fraser LSM, Philpott S, et al: Evidence of Stage Shift in Women Diagnosed With Ovarian Cancer During Phase II of the United Kingdom Familial Ovarian Cancer Screening Study Journal of Clinical Oncology 2017 35:13, 1411-1420
- Skates SS, Greene MH, Buys SS, et al Early Detection of Ovarian Cancer using the Risk of Ovarian Cancer Algorithm with Frequent CA125 Testing in Women at Increased Familial Risk – Combined Results from Two Screening Trials. Clin Cancer Res July 15 2017 (23) (14) 3628-3637
- Lifford KJ Clements A, Fraser L, al. A qualitative study of women’s experiences of familial ovarian cancer screening. Psychooncology. 2013; 22:2576-84.