NICE recommends new age-based thresholds for ovarian cancer screening

The National Institute for Health and Care Excellence (NICE) has proposed age-based thresholds for ovarian cancer screening to help identify women at higher risk earlier.

Previously, testing has used a blood test for cancer antigen 125 (CA125), a protein marker linked to ovarian cancer, with women showing 35 IU/mL or above referred for checks regardless of age.

Experts say this fixed threshold can miss cancers in older women while prompting unnecessary investigations in younger women.

In a draft update to guidelines, the NICE proposes more personalised criteria to reflect changing risk with age.

It adds that CA125 alone is not accurate enough to guide decisions for women under 40 and recommends ultrasound for those with persistent symptoms.

Eric Power, deputy director of the centre for guidelines at NICE, said: “The committee’s proposed recommendations will ensure more personalised, targeted testing, so women at greatest risk of ovarian cancer are identified and referred sooner.

“This tailored approach will mean GPs can make more informed decisions about which patients need urgent investigation, while reducing unnecessary ultrasound scans, freeing up NHS resources.

“These updates will ensure that our guideline reflects the latest evidence and will help improve the detection of cancer and ensure those who need it get swift treatment.”

The draft also proposes that people aged 60 and over with unexplained weight loss of more than five per cent over six months receive further investigation or suspected cancer pathway referral.

Amid rising hormone replacement therapy use in England, NICE also calls for more research into when unexpected bleeding while on HRT should trigger checks for endometrial cancer, which affects the womb lining.

There are an estimated 7,000 new ovarian cancer cases and nearly 4,000 deaths in the UK each year.

Only one in five patients are diagnosed early, when treatment is more likely to succeed.

Of those diagnosed early, 93 per cent survive more than five years, compared with 13 per cent diagnosed later.