New personalised risk score could improve ovarian cancer detection

Researchers from Queen Mary University of London have developed and validated a new tool that could help GPs detect ovarian cancer earlier and improve patient outcomes cost-effectively.  

Ovatools combines results from a standard blood test which measures the levels of a protein Cancer Antigen 125 (CA125) with a woman’s age, to provide a personalised risk score for ovarian cancer. Two new studies, funded by Cancer Research UK (CRUK) and the National Institute for Health and Care Research (NIHR), analysed data from over 340,000 women across England. They show that this approach is accurate, especially for women aged over 50 and represents good value for the NHS.  

The first study demonstrated that Ovatools could improve ovarian cancer detection in women aged over 50 years and identify those at higher risk for urgent referral and specialist assessment.  

The second study found that adopting the tool for women aged over 50 would be cost-effective, detecting more cancers earlier while remaining within the affordability threshold used by the National Institute for Health and Care Excellence (NICE). Both studies are published in British Journal of Cancer.  

Ovarian cancer is the sixth most common cause of cancer death in women in the UK. Most cases of ovarian cancer aren’t picked up until the disease is already advanced and difficult to treat. Currently, women with symptoms such as bloating or abdominal pain are offered a CA125 blood test by their GP, with a referral for an ultrasound only if the results exceed a fixed threshold. However, the risk of ovarian cancer varies with age as well as blood test levels. Ovatools accounts for both factors, identifying high-risk women more reliably.  

 Dr Garth Funston, Clinical Senior Lecturer at Queen Mary and an author of the study, said: CA125 is already widely used by GPs as a test in women with symptoms of possible ovarian cancer, such as persistent bloating or abdominal pain. By combining a woman’s CA125 level and the age, Ovatools gives us a better indication of a woman’s risk of having ovarian cancer. As a GP I think these findings could be really helpful in selecting which women need urgent investigation and referral.” 

Professor Danny McAuley, Scientific Director for NIHR Programmes said: "This tool brings real power into the hands of GPs, giving them the ability to detect patients who are at a higher risk of ovarian cancer, and getting them the specialist help they need sooner. This is an important step forward in our quest to drive better outcomes for patients." 

Dr Sarah Cook, Senior Strategic Evidence Manager at Cancer Research UK, said: "Identifying when to refer patients with possible ovarian cancer for further assessment can be challenging. Risk stratification tools like Ovatools offer valuable support to GPs, helping guide clinical decisions and ultimately improving patient outcomes. While further research is needed to understand the impact in real-world settings, the emerging evidence is compelling - and it’s crucial that the NHS is prepared to adopt and implement these kinds of innovations." 

"It’s important that people speak to their doctor if they notice any changes that aren’t normal for them. Possible symptoms of ovarian cancer include abdominal pain, persistent bloating, loss of appetite, and changes to bladder or bowel habits. These symptoms can be caused by conditions other than cancer, but it’s always best to get them checked,” she continued. 

Ovarian cancer affects around 7,500 women each year in the UK. Most are diagnosed at a late stage, when survival is poor. Five-year survival is over 90 per cent for women diagnosed at stage 1 but falls to around 16 per cent at stage IV.