Ovarian Cancer DNA Detected in Vaginal Fluid

A screening test for ovarian cancer is possible after its
DNA was detected in vaginal fluid.
Researchers have found it's possible to detect ovarian cancer gene mutations in vaginal fluid samples, a finding they hope is a step toward an effective screening test for the disease. In a pilot study, researchers were able to detect tumor DNA in tampons from several women with advanced ovarian cancer. It's a "proof of principle" that genetic evidence of the cancer can be uncovered in vaginal samples, they noted. The findings will appear in the November issue of Obstetrics & Gynecology.
Ovarian cancer is highly treatable if it's caught in the early stages, but most women are diagnosed only after the cancer has advanced. Because of that, only 44 percent of women with the disease survive for five years, according to the American Cancer Society. A woman might have abdominal bloating or urinary symptoms, for instance, but those problems are much more likely to have causes other than ovarian cancer. And right now, there is no effective screening test for the disease. Ovarian cancer is relative uncommon, so a potential screening would have to be sensitive enough to reliably catch the disease early, but have a low risk of false alarms, and unnecessary invasive procedures.
 
In the United States, about 22,000 women will be diagnosed with ovarian cancer this year, and almost 14,300 will die, according to the American Cancer Society. The risk goes up with age (most cases develop after menopause), and women with a family history of ovarian cancer are at higher-than-average risk.
 
Researchers have long sought a good screening test for the disease; it's considered the "holy grail" in battling gynecologic cancers. But only recently has there been the technology capable of detecting tiny bits of tumor DNA in vaginal fluid. To put it to the test, the research team analyzed fluid samples, obtained with tampons, from eight women with advanced ovarian cancer.
Three of those women had had their fallopian tubes "tied", and there was no evidence of tumor DNA in their vaginal fluid. But of the five women with intact fallopian tubes, three had tumor DNA in their samples.
 
That's a 60 percent rate, which is not good enough.  One of the next steps, is to try to refine the test to make it more sensitive. The researchers also plan to study women with early stage ovarian cancer, to see if DNA mutations are detectable at that point. That will be key for the test to be used for screening or early diagnosis. Since ovarian cancer is fairly rare, any screening test would have to be "outstanding" for it to be widely used, in the way mammography is used to screen for breast cancer, for example. But screening tests could be targeted to certain women, such as those who carry BRCA gene mutations, which confer high risks of breast and ovarian cancers.
 

Besides the questions about effectiveness, the technology used in this study is still too expensive for widespread use, but the researchers noted that with time they expect the costs to drop substantially.