Finding a “silent killer”
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Finding a “silent killer”
Our Review Summary
Cancer Antigen 125 (CA-125) is a protein found on the surface of certain types of ovarian cancer cells. The CA-125 test is used to monitor and guide treatment for ovarian cancer but has not been shown to be an effective screening test for average-risk women. This is because the test can come back elevated for many reasons and the false positive rate is high. However, according to new, unpublished results to be presented at next month’s American Society of Clinical Oncology (ASCO) meeting, monitoring change in CA-125 over time and incorporating other factors to identify higher-risk women for additional testing may identify ovarian cancers at a stage when they are treatable.
The full results have not yet been presented or published and a larger, ongoing study in the UK should provide more clarification as to whether this method should be used for widespread screening. Until then, caution should be used in interpreting these results.
This story meets all of the criteria in relatively few words. It provides an adequate description of the current study, quantifies the benefits and harms of the test and compares it to existing alternatives (of which there are none). It does not engage in disease mongering and quotes an independent expert who provides valuable insight.
The story does mention how much the blood test and ultrasound cost, but could have raised the question of whether this might be too expensive given that thousands of women must be tested in order to find one case of ovarian cancer.
Why This Matters
Key perspective in the story from Dr. Len Lichtenfeld of the American Cancer Society: “More research and refining needs to be done before it should be implemented. I can remember when doctors all rushed to adopt the Prostate Specific Antigen test, and we still don’t know how to use it.”
Criteria
Satisfactory
The story does mention how much the blood test and ultrasound cost. The story could have raised the question of whether this might be too expensive given that thousands of women must be tested in order to find one case of ovarian cancer.
Satisfactory
The story provides the number of cancers identified and false positives.
Satisfactory
The story mentions false positive results and unnecessary exploratory surgery as potential harms of the test.
Satisfactory
The story adequately describes the current study and provides some much-need caveats in interpreting the results.
Satisfactory
The story does not hype the seriousness or prevalence of ovarian cancer. It is a devastating diagnosis.
Satisfactory
The story quotes an independent expert from the American Cancer Society who provides much-needed perspective.
Satisfactory
The story is clear to say that there is no good existing screening method and that using CA-125 alone has been proven inneffective.
Satisfactory
The CA-125 test is clearly available. What is not clear is whether the clinical algorithm used in this study to identify high risk women is available widely or only in a research setting.
Satisfactory
CA-125 is not new, as it is used to monitor and guide treatment for existing ovarian tumors. Its use as a screening tool for ovarian cancer is highly controversial. What is new is the idea of using a model and CA-125 testing over time to predict risk for ovarian cancer.
Satisfactory
Because the story quotes an independent expert and a patient, the reader can assume the story did not rely on a press release as the sole source of information.
Total Score: 10 of 10 Satisfactory
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