New test

Ovarian cancer can now be detected earlier

Ovarian cancer grows quickly and is usually only diagnosed very late.(Bild: Dr_Microbe - stock.adobe.com)

Around 750 women in Austria are diagnosed with ovarian cancer every year, most frequently between the ages of 50 and 70. Although it occurs very rarely, it is the 5th most common cause of tumor-related death in women. A new test should help to detect the disease earlier.

In most cases, ovarian cancer is only discovered late, as there are no noticeable symptoms at first. A new test (ROCA) is now being offered at the Ordensklinikum Linz Barmherzige Schwestern to improve early detection. "The screening is intended for healthy women who have an increased genetic risk but do not want to undergo preventative surgery," explains Prim. Univ.-Prof. Dr. Lukas Hefler, Head of the Department of Gynecology at the Ordensklinikum Linz and Convent Hospital Barmherzige Brüder Linz.

The new test can both improve the chances of recovery and prevent unnecessary operations.

Prim. Univ.-Prof. Dr. Lukas Hefler

Ovarian cancer grows rapidly and only shows symptoms such as an increase in abdominal girth, weight loss and unclear digestive complaints at a relatively late stage. There is currently no specific screening test. "The only way to diagnose changes in the ovarian area is an ultrasound examination through the vagina," emphasizes Prim. Prof. Dr. Lukas Hefler.

Tumor marker is not conclusive
If a malignant tumor is suspected, imaging procedures (CT, MRI) are also used. A blood test can also provide information about so-called tumor markers. In the case of ovarian cancer, this is the CA 125 protein, but neither the ultrasound nor the blood test can be recommended for general screening, as a normal CA 125 value does not guarantee that there is no cancer. Conversely, the CA-125 level also rises in other diseases such as endometriosis, fibroids or pregnancy. 

Genes responsible
Of the 750 ovarian tumors each year, around 10-15 percent are genetic. As with breast cancer, the two genes BRCA1 and BRCA2 also play a role in this case. If a woman has this unfavorable genetic constellation, the risk of developing ovarian cancer is ten to 20 times higher. In total, three out of 1000 women carry one of the two genes (BRCA1 and BRCA2).

Genetically predisposed, healthy women
For these affected women, the ROCA test is currently the best method for detecting ovarian cancer at an early stage. It is a mathematical model, an algorithm that combines the results of the blood test, age, menopausal status and family history to calculate the risk. The Ordensklinikum Linz Barmherzige Schwestern is the only hospital in Austria to offer this screening.

Affected women have to have their blood taken three times a year. As a result, they receive a calculation of the probability, which is displayed as either green, orange or red. Green means no risk, orange means close monitoring, red means a high probability and leads to further clarification steps such as ultrasound, laparoscopy or an operation.