Learn how a new test could help more accurately diagnose ovarian cancer, and what the drawbacks of the tool involve. Key TakeawaysA blood test for a biomarker called HE4 may improve diagnosis of ovarian cancer when used in conjunction with tests for CA-125, a commonly used biomarker, and a diagnostic algorithm.Ovarian cancer is often not diagnosed until it has
A team of U.K. researchers is developing a blood test that may potentially help detect and diagnose ovarian cancer earlier. But it’s too soon to say whether it will improve accuracy enough to put it into general use.
Currently, there is no single reliable or early detection test for ovarian cancer, so the U.S. Preventive Services Task Force “recommends against screening for ovarian cancer in asymptomatic women.”
Ovarian cancer is usually detected through a pelvic exam in a doctor’s office, a transvaginal ultrasound, and a blood test for a protein called cancer antigen 125 (CA-125). But high levels of this protein aren’t necessarily indicative of cancer—it can be elevated due to anything from pregnancy and menstruation to endometriosis.
Lead study author Chloe E. Barr, MBChB, a clinical research fellow in gynecology in the Division of Cancer Sciences at the University of Manchester, told Verywell via email that her team was looking at improving the diagnostic accuracy of CA-125 in primary care to ensure that negative results were truly negative.
The new blood test under Barr’s investigation looks for the presence of a different protein found in the blood, called human epididymis protein 4 (HE4). Early results published in the journal Cancers in April show that analyzing HE4 alongside CA-125 may allow for more accurate detection of ovarian cancer.
Because even the most common symptoms can be vague and easy to dismiss, ovarian cancer is difficult to detect before it has become advanced. Researchers are seeking better tests for this insidious cancer so that it can be diagnosed in earlier, more treatable stages.
Ovarian cancer tends to run in families, so a family medical history can provide clues or a basis for regular checkups.
The U.K. research team reported on using HE4 alone and in combination with CA-125 to see if it improved detection of ovarian cancer in a small population of 1,229 patients. The study group consisted of women who had ovarian cancer symptoms and were being screened in primary care practices.
Because the group of patients was small, the researchers also evaluated blood samples from 81 women who were already being treated for ovarian cancer.
Researchers found that the combination of testing for HE4 levels and CA-125 levels, along with a screening assessment tool called the Risk of Ovarian Malignancy Algorithm (ROMA), improved detection. This was especially true for women under age 50, a group in which diagnosis of ovarian cancer can be more challenging.
HE4 is already used as part of ROMA to assess the risk of finding ovarian cancer in women who have a solid mass in their abdomens. But these types of patients are likely to have already visited a healthcare professional. Such a mass could be a benign cyst or could be cancerous. At this point, ovarian cancer is already highly suspected, so HE4 is not currently being used either as a screening tool or as a diagnostic test as a part of the current protocol.
More research on the use of a test for HE4 levels is needed. but If the findings are validated, “there is a possibility that in the future, HE4 will be considered for use by the [general practitioner] in addition to CA-125 in women with symptoms of ovarian cancer,” Barr said.
Barr clarified her team does not envision that HE4 blood tests will be used as a screening tool for ovarian cancer in the general population.
“There isn’t enough evidence currently to suggest that it would be useful in this way.” she said. “Our study has only evaluated the marker in symptomatic women as a diagnostic tool.”
Ovarian cancer is the 10th most common cancer among women and the fifth leading cause of cancer-related death in women.
Experts caution against putting too much stock in a new ovarian cancer diagnostic test at this stage.
“I think we have to be very cautious at this point in saying that this test could be useful or effective at picking up ovarian cancer cases,” Emily M. Ko, MD, an assistant professor and associate fellowship director of the Division of Gynecologic Oncology at the University of Pennsylvania, told Verywell. “It’s important to view the results in the context of the patients researchers ran the tests on.”
Ko pointed out among the patients being treated in primary care settings in the U.K. study, only one case of ovarian cancer was detected. In fact, researchers found high HE4 levels in several hundred patients over age 50 who did not have ovarian cancer. These patients were then subjected to further testing and scanning for ovarian cancer and were needlessly worried, she said.
Finding a more accurate blood test for ovarian cancer would be helpful in detecting and diagnosing ovarian cancer at an earlier and more treatable stage. But the research in question is in early stages, which means larger studies are needed to confirm the accuracy of adding HE4 tests to the usual tests for diagnosing ovarian cancer.