Kentucky boasts life-saving

LEXINGTON, Ky. – It’s been 18 years since the University of Kentucky’s Ovarian Cancer Study got under way. That’s 200,000 screenings of 25,000 women, most of them older than 50, a few older than 25 with a history of ovarian cancer in their families, all of them asymptomatic.

These days, 70 women a day traipse up to the third floor of the Markey Cancer Center for a simple, painless transvaginal sonogram. The procedure lasts 10 minutes.

Over the years, more than 6,500 ovarian tumors have been found. Fifty-two of those tumors turned out to be malignant cancer.

Of the 52 women in the study with ovarian cancer, three-quarters were found to be at Stage 1 or 2, says John van Nagell, director of gynecologic oncology at the UK Medical Center. Typically only 25 percent of ovarian cancers are caught this early.

The survival rate for the 52 at UK at two years was 90 percent. Their survival rate after five years is better than 80 percent.

The national overall ovarian cancer survival rate at five years barely tops 50 percent. The survival rate for those when the cancer is found in its latter stages is as low as 30 percent.

It is not a common disease, but it is the most lethal female cancer, killing 15,000 American women every year. Other than transvaginal sonography, there currently is no other way to accurately identify ovarian abnormalities.

And there is no question that lives of Kentucky women have been saved.

So how come the study hasn’t prompted the adoption of the sonogram procedure in every gynecologist’s office in the country? Isn’t this the greatest tool to save women’s lives since, oh, mammography? Shouldn’t we be outraged that only Kentucky women are getting this lucky?

Good question. Maybe. And no.

Medical research just plain takes time. And, van Nagell says, the study of ovarian cancer is in its infancy. To establish some kind of wholesale protocol change for doctors – and for insurers who must agree to pay for it – there needs to be enough statistical power and analysis for the proper conclusions to be reached.

And we’re not there yet.

Van Nagell says that, optimally, in screening trials like this one, there’d be 200,000 women in a control group. But who wants to be in the group that doesn’t get screened? No one. And van Nagell is not about to limit access to such a potentially life-saving test.

“The reality is, we have to have a very large trial and we have to continue to compile data which is accurate,” he says, adding all the data collected must be reported.

Which means that the problems with the screening are faced head-on.

“The screening we do here is very accurate in detecting ovarian tumors,” van Nagell says.