The international ovarian tumor analysis (IOTA) ADNEX ultrasound test detected 96% of ovarian cancers in postmenopausal women and should become standard of care in the U.K., according to researchers who just published a new study comparing methods. “This is the first time that a head-to-head study of all available ovarian cancer tests have been done in the same population,” said lead author Sudha Sundar, MPhil, from the University of Birmingham.
Their study was published in Lancet Oncology September 30. The team compared all currently available ovarian cancer tests for postmenopausal women head-to-head.
Of the six diagnostic tests investigated, the IOTA ADNEX model, which looks at ultrasound features (how the lump looked), had the best accuracy of all and could detect up to 96% of women with ovarian cancer.
In this study, the IOTA ADNEX test outperformed the current standard of care in the U.K. significantly. The test used now, the risk of malignancy (RMI1) test identifies 83% of ovarian cancers.
“Here we studied their use with symptomatic, postmenopausal women who are most at risk of this cancer. Our trial found that the IOTA ADNEX ultrasound protocol had the highest sensitivity for detecting ovarian cancer compared to the standard of care and other tests,” said Sundar, who is professor of gynecologic cancer at the University of Birmingham.
The research team noted that the IOTA ADNEX model achieved 96% accuracy when delivered by NHS sonographers who were appropriately trained and received quality assurance. As most scans worldwide are carried out by sonographers rather than gynecologists, introductory free online resources have been created by the researchers for NHS staff to undergo the specialist ultrasound training and get certification and quality assurance.
She added that, “The ultrasound test also performs well when delivered by a trained sonographer who has received specific training and certification and quality assurance, and as the vast majority of ultrasound scans are performed by sonographers it is important that a new standard is able to be delivered by as many clinical professionals as possible.
“We found that the higher sensitivity of the IOTA ADNEX model is likely to lead to some women who don’t have cancer also being flagged up as having a higher risk of cancer. We however did discuss this extensively with patients, cancer charity Target ovarian cancer and NHS experts who all agreed that in postmenopausal women who are at higher risk of ovarian cancer, picking up more women with cancer would benefit women overall.”
Annwen Jones, chief executive at the U.K. charity Target Ovarian Cancer said, “Early diagnosis of ovarian cancer is vital, and we are pleased to see this research demonstrate that there are more accurate ways of using ultrasound. The faster and earlier ovarian cancer is diagnosed, the easier it is to treat and the more successful the outcomes. Alongside this innovative research we need to see greater awareness of the symptoms of ovarian cancer so that women know to come forward to their GP for testing and receive the best possible treatment as quickly as possible. It is crucial that new ways of working like this are rolled out as quickly as possible.”
