Periodic screening for ovarian cancer, a must for Indian women

Periodic screening for symptoms of any disease, cancer or otherwise, is the best approach for catching it early. Yet, this does not work very well for detecting ovarian cancer. The symptoms of ovarian cancer – bloating, difficulty in eating, feeling full and feeling the need to use the bathroom often – are generic enough to lead to a diagnosis of other health problems

Periodic screening for ovarian cancer, a must for women

Ovarian cancer is the fifth most lethal cancer seen in women in USA and UK. In India, however, it is the third most commonly seen cancer in women. The most worrisome part is that an increase in the incidence of ovarian cancer in India is noted in women younger than 60 years of age.

While ovarian cancer typically develops in Caucasian women in their sixties, a younger slice of the population, ranging from 35 to 55 is affected by this aggressive cancer in India.

Another issue with this particular cancer is that the overall survival rate is only 30% for stage III tumours and 15% for stage IV tumours. In India, most cases of ovarian cancer are detected in stages III and IV.

Periodic screening for symptoms of any disease, cancer or otherwise, is the best approach for catching it early. Yet, this old jungle saying does not work very well for detecting ovarian cancer.

For starters, the symptoms of ovarian cancer – bloating, difficulty in eating, feeling full and feeling the need to use the bathroom often – are generic enough to lead to a diagnosis of other health problems.

Hence, transvaginal ultrasound imaging and monitoring the level of CA-125 protein in the blood have been considered as optimal screening tests for detection of ovarian cancer so far.

However, the latest update published by the United States Preventive Services Task Force (USPSTF) states that screening for ovarian cancer by CA-125 levels is not of high predictive value.

Screening women with symptoms to understand their levels of CA-125 protein in blood is not a useful strategy for fixing their risk for development of ovarian cancer. This means that a lot of women who get identified as high-risk ovarian cancer individuals by these tests are not actually at risk.

What would work as a good screening test?

The answer is ad hoc genetic screening for presence of mutations that increase a woman’s risk for developing ovarian cancer. Therefore, screening for the presence of genes involved in this hereditary syndrome is one strategy that can assess risk, far more accurately.

In addition, there are other hereditary syndromes, like Lynch Syndrome and Li-Fraumeni Syndrome, which can result in the development of ovarian cancer. There are genetic tests available to understand whether genes involved in these syndromes are also present in a person.

Prevention is better than cure, and through the genetic screening for ovarian cancer, one can anticipate the risk or probability of being diagnosed with the same. Doctors emphasise saying, it is highly advised that women go for genetic counselling where there is a family history of cancer and based on their counsellor’s advice get tested for ovarian cancer.

Dr Amit Agarwal is a leading oncologist based in Delhi  

Dr Sudhir Borgonha is the Chief Medical Officer, Strand Life Sciences, Bengaluru