On March 21, 2024, the National Institute for Health and Care Excellence (NICE) released new guidelines to help the NHS identify and support individuals at high risk for ovarian cancer. Here’s a breakdown of what you need to know:
Identifying High-Risk Individuals
The first step is to figure out who might be at high risk. A woman may be at high risk of ovarian cancer if there is evidence of the following :
- Family History: If you have a first or second-degree relative with ovarian cancer.
- Genetic Background: If you are of Ashkenazi, Sephardi Jewish, or Greenlander descent.
- Previous Testing: If you have already tested postiive to previous genetic tests.
- Specific Cancer Types: If you have non-epithelial ovarian cancer and haven’t yet had genetic testing.
Genetic Testing
If you’re at risk and agree to testing, the NHS may use a panel to test for genetic variants linked to ovarian cancer, specifically in up to nine genes (e.g., BRCA1, BRCA2). This will help to confirm your risk of developing ovarian cancer and decide on the next steps.
Supporting High-Risk Individuals
If you’re confirmed to carry a genetic variant that means you are at increased risk of developing ovarian cancer, you have a few options:
- Risk-Reducing Surgery: This involves removing ovaries and fallopian tubes to prevent ovarian cancer from developing. It’s recommended for:
- Women over 35 with a BRCA1 gene variant.
- Women over 40 with a BRCA2 gene variant.
- Women over 45 with variants in RAD51C, RAD51D, BRIP1, or PALB2 genes.
Surgery is suggested only if you’ve finished having children, and with psychological and menopause counseling provided beforehand.
- Preventative Medicines: Some individuals may benefit from medicines like aspirin (especially for those with Lynch syndrome) or the contraceptive pill (with considerations for breast cancer risk).
- Surveillance: For those who wish to delay or opt out of surgery, regular surveillance is recommended. This includes blood tests every four months and an annual review to reassess surgery plans. The ROCA® Test, which analyzes CA125 levels in the blood, is preferred to any other surveillance test for its accuracy and lower false results.
The ROCA® Test Explained
The ROCA® Test stands out for ovarian cancer surveillance. Here’s why:
- Accuracy: It’s better at correctly identifying who does and doesn’t have cancer compared to alternative tests.
- Early Detection: It can catch ovarian cancer earlier when it’s easier to treat. The ROCA Test is the only test shown in clinical trials to detect more ovarian cancers at an earlier stage.
- Affordable for the NHS: It’s also cost-effective, providing good value for the healthcare system.
The new NICE guidelines offer a comprehensive approach to managing ovarian cancer risk. They encourage more widespread genetic testing, preventative strategies, as well as surveillance. If a woman chooses to delay preventative surgery, the ROCA® Test is highlighted is recommended as the preferred surveillance test, providing a balance between accuracy and affordability. This new guidance aims to empower individuals with the knowledge and tools to manage their cancer risk proactively.