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.

A large, long-term study has found that the introduction of the human papillomavirus (HPV) vaccine in community settings is highly effective in protecting young women from infections caused by the cervical-cancer-causing virus—including women who didn’t even receive the vaccine.

HPV is the most common sexually transmitted infection worldwide and is the primary cause of cervical cancer.

HPV also causes other genital cancers as well as head and neck cancers in both women and men. According to the International Agency for Research on Cancer, HPV is responsible for more than 690,000 new cancer cases each year—about 4.5 per cent of all cancers globally.

Lead author Jessica Kahn, M.D., M.P.H. is professor of paediatrics and the Dr Ernest Baden Chair in Head and Neck Pathology at Einstein.

She said: “There are two encouraging takeaways from our study.

“First, HPV vaccines work remarkably well in a real-world setting, even among women at high risk for HPV and who may not have received all vaccine doses.

“Second, we saw clear evidence of herd immunity, meaning when enough people are vaccinated, the vaccine indirectly protects unvaccinated people by reducing overall virus transmission.

“These results reinforce the potential of the HPV vaccine to prevent infection and, ultimately, eliminate cervical cancer globally.”

The research team conducted six studies in Cincinnati of 2,335 adolescent and young adult women between 2006—just before the first HPV vaccine became available—and 2023.

Participants ranged in age from 13 to 26 at enrolment.

Many reported sexual behaviours that increased risk for HPV (79 per cent had two or more male sexual partners) and 51 per cent had a history of at least one sexually transmitted infection.

Over the 17-year study period, HPV vaccination rates rose from 0 per cent to 82 per cent. As vaccination coverage increased, the rates of HPV infection dropped dramatically among vaccinated participants

Infections from HPV types covered by the 2-valent vaccine fell by 98.4 per cent

Infections from types covered by the 4-valent vaccine dropped by 94.2 per cent

Infections from types covered by the 9-valent vaccine declined by 75.7 per cent

“These outcomes show that HPV vaccines are highly effective outside of controlled trials and could dramatically reduce rates of cervical cancer and other HPV-caused cancers, including other genital cancers and head and neck cancers,” said Dr Kahn.

The researchers also found strong evidence of herd immunity.

Among unvaccinated women, infections with HPV types covered by the 2-valent vaccine decreased by 71.6 per cent.

Meanwhile, infections with HPV types covered by the 4-valent vaccine dropped by 75.8 per cent

Dr Kahn noted that the high degree of herd immunity was likely related to robust vaccination rates and vaccination of boys as well as girls.

While there wasn’t enough data yet to confirm herd protection from the more recently introduced 9-valent vaccine, the results are promising.

“In the U.S. and other countries with widespread HPV vaccination programs, cervical cancer rates are already declining,” Dr Kahn said.

“Yet in 42 countries, it remains the leading cause of cancer death among women.

“Globally, only 27 per cent of girls have received at least one dose of this lifesaving vaccine – with coverage ranging from just 1 per cent in the Eastern Mediterranean region to 68 per cent in the Americas.

“By expanding uptake of this highly safe and effective vaccine, and ensuring access to screening and treatment, we can achieve one of the greatest public health victories of our time: the elimination of cervical cancer worldwide.”

AbbVie said on Monday that it will launch ovarian cancer drug Elahere in the UK at the same list price as in the US.

The announcement follows President Donald Trump’s push for drugmakers to align domestic prices with the lowest levels paid by comparable high-income countries under his “most-favoured-nation” policy.

The US currently pays nearly three times more for prescription medicines than other developed nations.

AbbVie is in talks with the National Institute for Health and Care Excellence, the UK’s cost-effectiveness watchdog, to ensure the drug is valued fairly.

The company said these discussions will determine when Elahere is launched in the UK. AbbVie did not immediately respond to a request on pricing.

The move comes after Bristol Myers Squibb said last week it plans to introduce its schizophrenia drug Cobenfy in the UK next year at a price matching its US list price.

AbbVie was one of 17 drugmakers to receive letters from President Trump in July outlining how they should cut prices to match those paid overseas.

Unlike in the US, where market forces determine drug prices, European governments typically negotiate directly with companies to set prices for their health systems.

Elahere, available in the US since 2022, belongs to a new class of therapies called antibody-drug conjugates, sometimes referred to as “guided missile” drugs.

These treatments use antibodies to deliver chemotherapy directly to cancer cells with a specific protein on their surface, allowing for more precise treatment while reducing harm to healthy tissue.