Ovarian Pap Test

By Jennifer Abney Anchor

Medical researchers seek an early detection tool for ovarian cancer. Ovarian Pap Test

Published: Mon, August 11, 2008 - 4:03 am Last Updated: Wed, August 20, 2008 - 8:43 am

Jennifer Abney

This year, the American Cancer Society estimates about 21,650 new cases of ovarian cancer will be diagnosed in the U.S. It’s the fifth leading cause of cancer death. Roughly 15,520 American women will die from the cancer in 2008.

The risk for ovarian cancer increases with age. Two-thirds of women with the disease are 55 or older at the time of diagnosis. Risk is also higher in women who are obese, don’t have children, take fertility drugs for more than one year, have a personal history of breast cancer or have a family history of ovarian cancer, breast cancer or colorectal cancer. Having several children, use of oral contraceptives, breast feeding, tubal ligation and hysterectomy (leaving the ovaries intact) are associated with a decreased risk for ovarian cancer.

Early Detection and Survival
If ovarian cancer is detected in early stages (before it has spread outside the ovary), treatment is often successful, with five-year survival rates of about 92 percent. However, less than 20 percent of the cancers are detected in early stages. Thus, the average five-year survival rate is just 45 percent.

There are two main reasons for the later stage of diagnosis. First, at early stages, ovarian cancer often has vague symptoms that can easily be dismissed (like bloating, abdominal swelling, pelvic pressure or increased urinary urgency or frequency). Second, there aren’t any adequate screening tests for the cancer. CA-125, a blood marker, is often higher in women with ovarian cancer and is sometimes used to screen women at high risk for the disease. However, elevated levels can be caused by other types of cancer. And in some cases, women with ovarian cancer have normal levels of the marker. Another test, transvaginal ultrasonography can detect unusual masses on an ovary, but can’t tell if they are malignant or benign. Currently, the only way to accurately diagnose the presence of ovarian cancer is through a biopsy or tissue sample taken from the ovary.

An Ovarian Pap Test
The traditional Pap test looks for abnormalities in cells taken from the cervix. It’s a fairly accurate screening tool for early diagnosis of cervical cancer. But it can’t be used to screen for ovarian cancer.

Now researchers at the NYU Cancer Institute are in the process of developing a similar type of test for ovarian cancer. Gynecologic Oncologist David Fishman, M.D., and his colleagues developed the ovarian Pap test. It is now being evaluated in a clinical trial. Doctors will take cell scrapings from the surface of ovaries in women who are having the organs removed for other reasons. Then, using molecular and genetic analysis, researchers will compare the genetic patterns and proteins of women who have a diagnosis of ovarian cancer against those who are cancer-free. Fishman hopes to be able to identify markers that indicate precancerous changes in the ovaries.

Fishman says it’s a daunting task. Scientists must look at tens of thousands of genes. In some cases, the difference between a cancer cell and a normal cell can be very miniscule. However, if the research shows the test is a valid prediction tool, it may one day be used to determine which women are at high risk for developing the cancer. A woman could then elect to have prophylactic ovary removal to reduce the risk of developing ovarian cancer. Fishman says the test may also be used to develop preventive strategies or better treatments for ovarian cancer.

The research is taking place at hospitals around the world. Women who are at risk for ovarian cancer can participate in this study by calling the NYU Cancer Institute at (212) 731-5345.

Women who are at risk for ovarian cancer can participate in the ovarian Pap test study by calling the NYU Cancer Institute at (212) 731-5345.

For general information on ovarian cancer:
American Cancer Society, http://www.cancer.org
National Cancer Institute, http://www.cancer.gov