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Ultrasound Test Could Detect 96% of Ovarian Cancers
An ultrasound test that detected 96% of ovarian cancers in postmenopausal women should replace the current standard of care test in the United Kingdom, according to a new study.
In a paper published in Lancet Oncology, research funded by the National Institute for Health and Care Research and led by Professor Sudha Sundar from the University of Birmingham compared all currently available tests to diagnose ovarian cancer in postmenopausal women head-to-head in a high-quality diagnostic test accuracy study.
Sundar, a professor of gynecological cancer at the University of Birmingham and consultant in gynecological cancer surgery at Sandwell and West Birmingham NHS Trust, says, “This is the first time that a head-to-head study of all available ovarian cancer tests has been done in the same population. Here, we studied their use with symptomatic, postmenopausal women who are most at risk of this cancer. Our trial found that the IOTA ADNEX ultrasound protocol had the highest sensitivity for detecting ovarian cancer compared to the standard of care and other tests.”
Of the six diagnostic tests investigated, the IOTA ADNEX model, which looks at ultrasound features (how the lump looks on ultrasound), had the best accuracy of all and could detect up to 96% of women with ovarian cancer.
“The ultrasound test also performs well when delivered by a trained sonographer who has received specific training and certification and quality assurance, and as the vast majority of ultrasound scans are performed by sonographers, it is important that a new standard is able to be delivered by as many clinical professionals as possible,” Sundar says.
The ultrasound test significantly outperforms the current standard of care in the United Kingdom, so it is recommended that the IOTA ultrasound ADNEX model should replace the current standard of care test called the risk of malignancy test in the United Kingdom, which identifies 83% of ovarian cancers.
“We found that the higher sensitivity of the IOTA ADNEX model is likely to lead to some women who don’t have cancer also being flagged up as having a higher risk of cancer. We, however, did discuss this extensively with patients, cancer charity Target Ovarian Cancer, and NHS experts who all agreed that in postmenopausal women who are at higher risk of ovarian cancer, picking up more women with cancer would benefit women overall,” Sundar says.
Annwen Jones OBE, chief executive at Target Ovarian Cancer, says, “Early diagnosis of ovarian cancer is vital, and we are pleased to see this research demonstrate that there are more accurate ways of using ultrasound. The faster and earlier ovarian cancer is diagnosed, the easier it is to treat and the more successful the outcomes. Alongside this innovative research, we need to see greater awareness of the symptoms of ovarian cancer so that women know to come forward to their GP for testing and receive the best possible treatment as quickly as possible. It is crucial that new ways of working like this are rolled out as quickly as possible.”
The research team notes that the IOTA ADNEX model achieved 96% accuracy when delivered by NHS sonographers who were appropriately trained and received quality assurance. As most scans worldwide are carried out by sonographers rather than gynecologists, introductory free online resources have been created by the researchers for NHS staff to undergo specialist ultrasound training and get certification and quality assurance.
Source: University of Birmingham
