Journal scan

Surveillance CA-125 tests continue in ovarian cancer despite little benefit

Tests and computed tomography scans may not improve women's survival or quality of life 
Routine tests

In spite of evidence from a large randomised controlled trial (RCT) in 2009, which suggested the use of cancer antigen 125 (CA-125) tests for routine surveillance in ovarian cancer may not improve a womans survival or quality of life, this American study suggests such practices continue.

As well as there being evidence for little positive effect in the RCT, there is evidence also that it might decrease quality of life, such as through increased use of chemotherapy.

There are also high financial costs associated with testing and the use of routine radiographic imaging, such as computed tomography (CT) scanning.

Through this prospective cohort study design, data on the use of surveillance testing at six National Cancer Institute designated cancer centres were analysed from a recent two-year period.

...

In spite of evidence from a large randomised controlled trial (RCT) in 2009, which suggested the use of cancer antigen 125 (CA-125) tests for routine surveillance in ovarian cancer may not improve a woman’s survival or quality of life, this American study suggests such practices continue.

Routine tests
CA-125 tests for surveillance in ovarian cancer are continuing despite evidence of little benefit. Pic: SPL  

As well as there being evidence for little positive effect in the RCT, there is evidence also that it might decrease quality of life, such as through increased use of chemotherapy.

There are also high financial costs associated with testing and the use of routine radiographic imaging, such as computed tomography (CT) scanning.

Through this prospective cohort study design, data on the use of surveillance testing at six National Cancer Institute designated cancer centres were analysed from a recent two-year period.

The data were compared for practices before and after the RCT findings, to determine if there had been any change.

After the RCT in 2009, clinical practice did not appreciably change, with 90% of women undergoing three or more CA-125 tests during a year’s follow up. While there was variability in institutional practice, the researchers found significant divergence from recommended practice where two-thirds of patients had undergone at least one CT scan within six months, and one third had submitted to three or more scans since the completion of their anticancer treatments.

Esselen K, Cronin A, Bixel K et al (2016) Use of CA-125 tests and computed tomographic scans for surveillance in ovarian cancer. JAMA Oncology. doi: 10.1001/jamaoncol.2016.1842.

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