Simple Blood Test Could Diagnose Ovarian Cancer Faster and Reduce Biopsies

Ovarian cancer is the sixth most common cancer in women in the UK with around 7,500 new cases every year. Almost one in five new diagnoses (18%) are in women under the age of 50. Currently, women with suspected ovarian cancer undergo a blood test to analyze the level of a protein called CA125 in their body. A high amount of this protein can be a sign of cancer, but it can also be caused by other conditions, such as menstruation, pregnancy, uterine fibroids and endometriosis. Nine in 10 women with raised levels of CA125 in their blood, who are then subject to further tests, do not have ovarian cancer. Meanwhile, some ovarian cancers may be missed if levels of CA125 are too low. This can result in diagnosis occurring when the cancer is more advanced. Now, a simple blood test that can be given by general practitioners (GPs) could help diagnose ovarian cancer faster and more accurately, particularly for women under the age of 50, according to new research.

In the new study, researchers, including scientists from the University of Manchester (Manchester, UK), investigated whether a type of protein found in the blood, human epididymis protein 4 (HE4), could help identify ovarian cancer more accurately and save other women from unnecessary and often invasive tests and procedures, such as physical examinations and biopsies. The researchers studied blood samples collected from 1,229 patients over a 12-month period. Samples were tested for HE4 and the team investigated the diagnostic accuracy of HE4 alone and in combination with CA125. The study concluded that HE4 levels, when analyzed alongside the current CA125 test and within an algorithm, could improve the detection of ovarian cancer, particularly in women under the age of 50.

Previous studies have highlighted HE4 as a promising cancer biomarker, but until now, tests have only been conducted in groups of women in hospital when a pelvic mass has already been detected. It is currently approved by the Food and Drug Administration (FDA) in the USA for monitoring remission. A larger-scale study is now recommended to confirm these findings.

“While our results require validation in a much larger sample, these findings are extremely promising. Ovarian cancer is notoriously difficult to diagnose at an early stage, as symptoms are often non-specific, including bloating, pain and feeling full quickly after eating. We also know that the current blood test we use to investigate symptomatic women for ovarian cancer in primary care – CA125 – is less accurate in younger women,” said Dr. Funston, an Academic Clinical Fellow in General Practice at the University of Manchester. “We hope our research can contribute to a change in how quickly ovarian cancer is identified. This is especially exciting as there has been little progress over the years towards developing more accurate ovarian cancer testing approaches for use in primary care.”

“This is the first time that HE4 has ever been evaluated in a primary care setting, so it will be exciting to see larger-scale studies implemented to further assess its effectiveness as a diagnostic aid. Earlier diagnosis will have important implications for women’s treatment, care and ultimately, survival,” added Professor David Williams, University College London.

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