Avoiding late diagnosis in ovarian (ALDO) cancer for BRCA mutation carriers "It is estimated that one in 400 women have a faulty gene, known as a BRCA mutation, which puts them at high risk of developing both breast and ovarian cancer. These women face many difficult decisions. As a doctor specialising in gynaecological cancers and inherited faulty genes, I see many women in my clinic who are worried about developing ovarian cancer. It’s clear that the most effective way of preventing ovarian cancer is to have risk-reducing surgery – removal of both ovaries and fallopian tubes. However, this type of surgery does have major side effects, particularly for pre-menopausal women, including infertility and early menopause. Unlike with breast cancer risk, there is no established NHS surveillance programme for women at high risk of ovarian cancer, and no national guidance apart from having risk-reducing surgery. This is why we are piloting the ALDO project – an NHS ovarian cancer surveillance service for BRCA mutation carriers aged 35 and over who haven’t yet had their ovaries and fallopian tubes removed. The project will recruit up to 2,000 women and uses the ROCA© blood test to detect ovarian cancer in BRCA mutation carriers before they have symptoms. Participants will have the test every four months and will be followed up if necessary. In a previous study the test detected nine out of 10 cancers, of which around two thirds were at less advanced stages. This is the first time that this technology has been piloted as an NHS service and the aim is to confirm the feasibility and cost-effectiveness of introducing ovarian cancer surveillance for BRCA mutation carriers across the NHS as standard practice. If you or someone you know is interested in taking part, you can find out more here: www.uclh.nhs.uk/ALDO " Dr Adam Rosenthal is a Consultant Gynaecologist at UCLH and Clinical Director for the ALDO project.