More than 200,000 women across 13 UK regions have joined a trial to find out whether routine screening for ovarian cancer can save lives. Ovarian cancer is often diagnosed late because symptoms are vague, and there is currently no national screening programme. This trial directly tests whether two screening methods—transvaginal ultrasound or a blood test called CA125—can detect the disease early enough to reduce deaths. It also measures the worry, complications, and costs that screening would bring to the NHS. If the trial shows that screening saves lives, it could lead to a national programme that catches ovarian cancer earlier, when treatment is more likely to succeed. If it does not, the NHS will avoid spending resources on a test that causes unnecessary anxiety and surgery without benefit. The trial has already found that women who volunteered to join are healthier than the general population, meaning fewer deaths than expected in the control group. This has forced an extension of the study to get a clear answer. The results will shape whether ovarian cancer screening becomes routine for older women in the UK.
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UKCTOCS aims to assess whether ovarian cancer screening will save lives while comprehensively evaluating the screening strategies available, the worry and complications associated with screening and ensuing surgery, compliance and the potential resource implications for the NHS. Women aged 50-74 in 13 regions in the UK were invited to take part. The 202,638 women who joined the study were randomly allocated to an observation (control) group or screening with transvaginal ultrasound (USS)for 6 years or screening with a blood test called CA125 for 6 years. All women are being followed up by postal questionnaire and through the Office for National Statistics to establish whether or not they develop ovarian cancer or die of the disease. Screening is ongoing and the study has met all its targets on recruitment, retention and follow up. Currently each woman is in the trial for 7 years from randomisation and the trial will be complete in 2012. Hoever, it is now clear that there are less deaths from ovarian cancer than expected in the women in the control group who have not been screened. As a result of thos healthy volunteer effect the trial needs to be extended to obtain a clear answer to the question - Can ovarian cancer screening save lives? The best approach will be to extend screening until 2011 and follow up everyone until 2014.
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