Piotr J. Wysocki: Do we finally have a promising screening method for ovarian cancer?

Piotr J. Wysocki, Professor of Medicine and Head of Department of Oncology at Jagiellonian University Hospital in Poland, shared on LinkedIn:

“A 21-year update of the NROSS (Normal Risk Ovarian Screening Study) revealed that a two-stage screening for ovarian cancer induces a stage shift with a 50% positive predictive value in detecting ovarian malignancy.

Almost eight thousand women (50,596 woman-years) have been examined using a two-stage approach. The first stage was based on the evaluation of Cancer Antigen-125, and if CA-125 levels were abnormal, patients were evaluated using transvaginal ultrasonography (TVUS). Patients with abnormal TVUS findings underwent surgery. Among 33 surgically treated patients, 15 ovarian cancers and two borderline tumors were detected. The sensitivity for detecting ovarian and borderline cancer was 74%, and 70% of cases (12 of 17) were in stage I-II. Additionally, the NROSS allowed for detecting 7 stage I endometrial cancers.

Compared to earlier studies, the NROSS approach led to a clinically relevant reduction of late-stage ovarian cancers by 30-34%.
Although the NROSS trial wasn’t powered to detect reduced mortality, its findings reveal a high specificity in detecting ovarian cancer (PPV > 50%) and any cancer (PPV > 74%), surpassing the study’s endpoint of PPV > 10% by a significant margin. Undoubtedly, these results from the NROSS trial strongly advocate for the continued development of this screening strategy.

Personally, I would discuss the results of the NROSS study with my patients who are cancer survivors and their family members who are nevertheless at increased risk of developing ovarian cancer.

Chae Young Han et al. Normal Risk Ovarian Screening Study: 21-Year Update. JCO 0, JCO.23.00141 DOI:10.1200/JCO.23.00141″

Source: Piotr J. Wysocki / LinkedIn