Study finds tests, scans to treat ovarian cancer not always necessary

While the costs of cancer continue to rise, examining which treatments are worth the time and money is increasingly more important to physicians looking to find the most affordable and effective treatments.

New research from the American Society of Clinical Oncology and the Society for Gynecologic Oncology suggests traditional methods for treating ovarian cancer might not be as effective as they were once thought to be. The study, published in JAMA Oncology July 21, showed that CA-125 tests, which measure the amount of cancer proteins in the blood, and CT scans are not proven to have any significant implications on patients suffering from ovarian cancer. The researchers found that such procedures do not necessarily improve patients' quality of life.

The study was led by Katharine Esselen, MD, MBA, a doctor of obstetrics and gynecology at Boston-based Beth Israel Deaconess Medical Center. She’s also a professor of obstetrics and gynecology at Harvard Medical School.

In a prior clinical trial about CA-125 tests done in 2009, researchers found that using the tests for routine surveillance in ovarian cancer increased the use of chemotherapy and decreased patients’ quality of life—both without improving survival based on clinical observation. After that study, the Society of Gynecologic Oncology advised that CA-125 testing be optional and discouraged the use of radiology scans.

However, the new study examines the use of CA-125 tests in clinical practice. In it, more than 1,200 women at six National Cancer Institute centers were followed from 2004 to 2012 and from 2014 to March 2016 to examine how the use of CA-125 tests and CT scans influenced their . The women studied were in clinical remission after undergoing primary cytoreductive surgery and chemotherapy.

The researchers found that the use of CA-125 tests and CT scans cost about $16 million a year and didn’t have a large impact on positive outcomes for patients.

“Our results demonstrate that the recommendation to avoid routine surveillance testing has not been adopted into clinical practice in the United States,” the authors wrote in the study. “Similarly, although the routine use of CT scans has been strongly discouraged by guideline committees, CT scans appear to be routinely used, at significant cost. These practices have significant, but poorly understood, psychosocial and cost implications, and no benefit on survival to date.”

Looking ahead, the researchers suggest that future studies look at what patient populations benefit most from surveillance testing and whether it improves the value of cancer care for them.

The study was funded by grants from the National Cancer Institute and the Cancer Prevention and Research Institute of Texas.