Ovarian cancer is the eighth most common cancer in women worldwide, and the leading cause of mortality from gynaecological malignancy. As its symptoms—abdominal bloating, feeling full quickly after eating, and back pain—are not unique to ovarian cancer, it is often difficult to diagnose at an early stage. Women diagnosed with Stage I ovarian cancer are more than 90% likely to be alive five years after their diagnosis, but this falls to 13% for those diagnosed with Stage IV disease. A UK study published at the end of last month, however, found that a new blood biomarker improved the detection of ovarian cancer, results that could one day lead to the development of a blood test to diagnose the cancer more quickly and accurately. If such a test becomes common practice for diagnosing ovarian cancer, GlobalData epidemiologists expect incident cases in the UK to increase.
The study, conducted by Barr and colleagues and published in Cancers, assessed the diagnostic accuracy of the new protein, HE4, alone and in conjunction with the currently used test, CA125, in 1,229 primary care patients in the UK. High CA125 levels in the blood may signal cancer, but other conditions, such as endometriosis and uterine fibroids, can also raise them. In addition, the current blood test is less accurate in younger women. The authors found that ovarian cancer detection was improved when HE4 levels were analysed alongside CA125, particularly for women aged younger than 50 years. The combined test correctly identified younger women with ovarian cancer 100% of the time and those without cancer 80% of the time.
In the UK, GlobalData epidemiologists expect a slight increase in diagnosed incident cases of ovarian cancer in women aged younger than 50 years, exceeding 1,300 cases by 2028, while incident cases in women aged 50 years and older will approach 7,000 (Figure 1). If a new blood test analysing both the HE4 and CA125 proteins is developed and implemented widely in a primary care setting, GlobalData epidemiologists expect incident cases to increase above those currently forecast, particularly in women aged younger than 50 years, as more cases are diagnosed earlier.
About 16% of new ovarian cancer diagnoses are in women aged younger than 50 years. The current blood test can lead to unnecessary and more invasive testing in women with raised CA125 levels who do not actually have ovarian cancer while also missing some cancers if levels are too low. HE4 testing offers a promising avenue for earlier and more accurate detection, which would in turn impact treatment and survival. GlobalData epidemiologists recommend continued monitoring of trends in ovarian cancer and larger-scale studies to confirm these findings.