NHS introduces new ovarian cancer screening for high-risk women

High-risk women can now delay ovary removal surgery through NHS screening, helping them preserve fertility and avoid early surgical menopause.

The ROCA test tracks women with BRCA gene mutations every four months, monitoring cancer risk markers instead of requiring immediate preventive surgery.

University College London Hospitals NHS Foundation Trust has begun rolling out the programme, with plans for national expansion after approval from the National Institute for Health and Care Excellence (NICE).

BRCA1 and BRCA2 mutations greatly increase the risk of breast and ovarian cancer. Normally, BRCA genes repair damaged DNA, but when faulty they allow tumours to grow more easily.

Breast cancer screening with mammograms is long established, but until now there has been no equivalent for ovarian cancer. Women carrying BRCA mutations were typically advised to have their ovaries removed preventively – a step that ends fertility and triggers menopause immediately.

The ROCA test monitors changes in CA125, a blood protein that can indicate ovarian cancer when levels rise.

By testing every four months, women can keep track of their risk while delaying surgery if they wish.

Professor Adam Rosenthal, consultant gynaecologist at UCLH, said the test was designed as a damage-limitation option for women not ready for surgery.

A raised result means patients can reconsider surgery, while regular monitoring increases the chance of detecting cancer early, when outcomes are better.

Natasha Wray learned she carried the BRCA gene after breast cancer treatment at 36. She was advised to have her ovaries removed but refused.

She said: “I was 36 at the time, and I said, absolutely not. I’d just gone through seven rounds of chemo, extensive surgery, and had sort of a year and a half, two years of my life caught up in cancer treatment, and I just wanted to be left alone.

“And I also didn’t want to go through a surgical menopause in my mid-30s.

“I also very much wanted to be a mum, so I definitely wanted to hold on to any fertility that I did have.

She initially paid privately for the ROCA tests and admitted they brought anxiety.

But Rosenthal said the screening helps keep the decision about surgery at the forefront for patients.

At 41, Wray had a baby. Two years later, her test results showed raised CA125 levels, and she delayed before eventually choosing surgery.

“It wasn’t easy,” she said.

“But I do think it’s really important as well that women’s bodies aren’t just seen as baby making bodies and machines.

“I very much wanted to be a mother. That wasn’t my sole purpose for holding onto my ovaries.

“It was very personal and it actually had nothing to do with anybody else. It was very much me, how I felt in my body, what had already been felt like to me, taken from me.”

NICE has approved the ROCA test for BRCA carriers, with health officials highlighting its cost-effectiveness and aiming to make it available across England.