Co-Investigators - Prof Mahesh Parmar; Prof Ian Jacobs; Dr Steve Skates, Prof Alistair McGuire; Prof Stuart Campbell; Prof Dame Lesley Fallowfield
The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) trial has involving 202,000 women has shown that it is possible to detect ovarian cancer with high sensitivity, specificity, positive predictive value, acceptability and compliance using a multimodal screening strategy which combines serum CA125 interpreted using the risk of ovarian cancer algorithm, transvaginal ultrasound and clinical assessment.
As with other forms of cancer screening, there was unnecessary surgery but the surgical false positive rate with multimodal screening was lower than with any other prospectively evaluated screening strategy for ovarian cancer. One in four women who underwent surgery had ovarian cancer.
Both at three and at nine and half years after end of screening, there was a significant increase in women with early-stage (stage I and II) and decrease in women with advanced-stage (stage III and IV) ovarian and tubal cancers in the multimodal group compared to the no screening group.
There was no difference in stage of women with ovarian and tubal cancers in the ultrasound group compared to the no screening group.
At median follow up of 11.1 years there was a nonsignificant reduction in ovarian and tubal cancer deaths in the multimodal screening group compared to the no screening group
At median follow up of 16.3 years there was no reduction in deaths from ovarian and tubal cancer in the multimodal or ultrasound group compared to the no screening group.
The results indicate that currently ovarian cancer screening cannot be recommended in the general population.
The results also illustrate the importance of specifying cancer deaths as the primary outcome in screening trials, given that detecting more women earlier with Stage I and II disease did not translate into lives saved
UKCTOCS Longitudinal Women’s Cohort (UKLWC)is the bioresource created during the course of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Donated samples and data continue to be used for secondary research. More details can be found here.
ISCRTN number: 22488978
UKCRN ID: 786
North West Multicentre Research Ethics Committee Reference 00/8/34
Initial approval: 21st June 2000
Extended follow up till 31st December 2024
Detailed protocol of long term follow-up: version 9.0 19th Feb 2020