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Ovarian Cancer Surveillance Test Effective in 'Real-World' Study

A test designed to measure the risk of ovarian cancer for women with pathogenic germline BRCA1/2 variants has been shown to be effective in a real-world study, detecting early-stage disease and improving clinical outcomes. The findings, which are reported in the Journal of Medical Genetics this week, suggest that the test could be used to track high-risk women who defer risk-reducing bilateral salpingo-oophorectomy (RRSO). Not all women with pathogenic BRCA1/2 alterations are willing to undergo RRSO to prevent ovarian cancer, making effective surveillance an important option. Abcodia developed a test — called the Risk of Ovarian Cancer Algorithm (ROCA) — that calculates the probability of a woman having epithelial ovarian cancer or fallopian tube cancer by assessing the rate of change of the tumor biomarker CA125. Following positive results from clinical studies of the test, a group led by University College London scientists set out to evaluate its real-world performance in hundreds of women throughout the UK with pathogenic BRCA1/2 variants who declined RRSO. They find that ovarian cancer surveillance using ROCA had similar real-world performance as in research trials and that it could offer cost savings to the UK's National Health Service. "While RRSO remains recommended management, ROCA-based surveillance may be considered for female BRCA-heterozygotes who are deferring such surgery," the study's authors conclude.