UKCTOCS

What was this study about?

Ovarian and tubal cancers are the leading cause of death from gynaecological cancers in the UK. Most women are diagnosed with advanced stage disease which is associated with poor survival. UKCTOCS was a multi-centre randomised controlled trial that evaluated whether it would be possible to save lives of women diagnosed with ovarian and tubal cancer in the average-risk population by using screening to detect the disease earlier, when treatments are more effective.

Two forms of annual screening were tested:

• (i) multimodal screening (MMS) using blood tests to assess changes in the serial profile of a cancer biomarker called CA125 followed by transvaginal (internal) ultrasound in those where the test was not normal
• (ii) ultrasound screening (USS) using transvaginal ultrasound scan.

Women in the screen arms underwent 7-11 annual screens. All women were followed up through national cancer and death registries to assess if they had developed ovarian cancer or died of the disease.

 

What difference did this study make?

UKCTOCS is the largest ovarian cancer screening trial to date.

Screening in UKCTOCS did not reduce deaths due to ovarian and tubal cancer. However, there was robust evidence that multimodal screening can detect ovarian cancer, especially the most common and aggressive type (high grade serous ovarian cancer) earlier and improve short term outcomes. Additionally, the trial showed that looking at changes in an individual’s cancer biomarker levels over time can improve the performance of the screening test and that ultrasound scans cannot detect early tubal cancers.

While the trial findings do not support ovarian cancer screening using CA125 and ultrasound, it suggests that novel approaches that can detect more women earlier in the course of the disease are likely to reduce deaths.

The trial biobanks with over half a million samples provide the opportunity to evaluate novel biomarkers and are being used in a large number of secondary studies on early detection of cancer. In addition, the design, conduct and analysis of UKCTOCS has generated insights into all aspects of large-scale screening trials that span decades.

Type of study

Randomised trial

Contact details

ukctocs@ucl.ac.uk

Data Sharing

UKCTOCS Longitudinal Women’s Cohort (UKLWC) is the bioresource created in the course of UKCTOCS. The women provided consent for use of data and samples as part of research collaborations involving ethically approved secondary studies. Please find more information at https://uklwc.mrcctu.ucl.ac.uk/access-process/ Please email Dr Sophia Apostolidou (s.apostolidou@ucl.ac.uk) if you wish to explore collaborations.

Who funded the study?

UKCTOCS was funded by Medical Research Council, National Institute for Health Research, Cancer Research UK and The Eve Appeal.