Ovarian cancer is the deadliest cancer of the women’s reproductive system. It kills 12,450 women in the US each year.
Part of the reason it’s so lethal is that there is no universal screening program for the cancer and many testing options aren’t reliable. That leaves cancer free to grow in many patients, with doctors only able to find it once the disease has reached a late stage and it’s already spread to other organs.
Some women at higher risk turn to hysterectomy — a full removal of their ovaries and fallopian tubes — to lower their risk.
But now, a simple blood test could revolutionize this process, catching ovarian cancer before tumors develop, early research suggests.
“Ovarian cancer does not begin the day we discover a tumour. It often begins much earlier, with microscopic changes in the fallopian tubes that we can’t see during routine screenings,” said author Dr. Rajan Gogna.
“For women at high risk, this could transform how we approach prevention,” added Dr. Esha Madan.
How it works
Ovarian cancer is currently detected after tumors have already formed.
“We asked a fundamentally different question: What if we could identify the earliest molecular warning signs before invasive cancer even develops?” said Gogna.
Researchers specifically looked at high-grade serous carcinoma (HGSC), the most common type of epithelial ovarian cancer and the cause of a majority of ovarian cancer deaths.
Scientists believe HGSC starts in the fallopian tubes, where precancerous microscopic lesions called serous tubal intraepithelial carcinomas (STICs) develop. These don’t produce symptoms and are only found after the fallopian tubes are surgically removed and examined under a microscope.
Researchers wanted to see whether levels of Tu-stroma, an RNA biomarker found in the blood, could reveal the presence of developing STIC lesions. The authors believe abnormal cells release tiny packages containing Tu-stroma, some of which enter the bloodstream.
The study found evidence that Tu-stroma worked as a biomarker for STIC. The test detected STIC in 92.3% of women who had it, and correctly found 98.2% of women who didn’t.
When modeled to a high-risk population, researchers said it would detect STIC correctly 72% of the time, and correctly identify negative cases nearly 100% of the time.
Possible impacts
Women who are at high risk of getting ovarian cancer would have genetic mutations, family history, or personal history that contribute to risk.
BRCA1 and BRCA2 are associated with breast cancer, but also dramatically increase risk of ovarian cancer too. Having a first degree relative (mother, daughter or sister) with ovarian, breast or colorectal cancer also increases risk. Also, if the patient themselves had breast or colorectal cancers or endometriosis, it also increases their risk of getting ovarian cancer.
To lower risk, doctors may recommend surgery to remove the fallopian tubes and ovaries. But this still doesn’t eliminate the risk entirely.
“Today, decisions about preventive surgery are largely guided by inherited risk, without knowing whether precancerous lesions are actually present. Our discovery could eventually provide that missing biological information,” said Madan.
While this test shows promise, it’s not yet a clinically validated blood test. Researchers will need to continue collecting blood samples and following participants over time to see how reliably it works.
“Our vision extends beyond early detection. We are already working on innovative approaches aimed at stopping these microscopic lesions from progressing, potentially eliminating the need for preventive surgery altogether,” Madan said.
“Our ultimate goal is not simply to detect ovarian cancer earlier, but to prevent invasive cancer from ever developing.”
