Data from a large NIH-sponsored study has shown that annual screening for ovarian cancer fails to detect early-stage disease and generates frequent, unnecessary surgeries to boot.

In a study conducted by Edward Partridge and colleagues at the University of Alabama at Birmingham, more than 70% of cancers detected by transvaginal ultrasound and CA 125 biomarker testing were stage III or IV at the time of diagnosis.

That’s about what happens when women aren’t screened at all.

“These data suggest we need a better screening tool,” Partridge said in a statement picked up by MedPageToday. “We need a test that is more sensitive and more specific so we find the cancer earlier and we catch the biological markers that give us stronger clues.”

The write-up is in Obstetrics & Gynecology.

The scientists enrolled 34,261 healthy women with intact ovaries who were between the ages of 55 and 74.

Compliance with both screening tests was 83% at baseline and stayed high at 78% through the fourth round.

In Year 1 of the program, positive test results obligated 566 surgical procedures which uncovered only 18 cancers, more than 80% of which were stage III or IV.

In the subsequent 3 years, 604 surgeries followed a positive test result, and 42 invasive cancers were found. Here again, most of the malignancies were stage III or higher.

On the false-negative side of things, overall, 89 cases of ovarian cancer were diagnosed during the study, and a third of them had been missed altogether by both screening modalities.

The study’s primary endpoint, which is impact of annual screening on ovarian cancer mortality, has yet to be determined. Bet the house on no impact.

Plavix-popping patients in posession of a particular gene that prevents its proper metabolism were at twice the risk of sustaining cardiovascular events, and the risk could not be mitigated by high doses of the stuff, according to 2 studies presented at last week’s meetings of the American College of Cardiology.

In the first study, Paul Gurbel and colleagues showed that 21% of patients with the cytochrome P450 2C19*2 polymorphism had a cardiovascular event within a year following coronary artery stenting, even though they received Plavix to prevent such occurrences.

The University of Maryland-based scientists found that only 10% of noncarriers experienced that outcome.

“This common variant encodes a defective enzyme that likely fails to convert Plavix to its active metabolite, leading to lesser inhibition of platelet function and diminished cardiovascular protection,” Gurbel told MedPageToday.

In the second study of 33 patients that had a poor response to the standard 75 mg dose of Plavix, Jean-Philippe Collet and colleagues at INSERM in Paris found that doubling the standard dose improved results in all but 7 patients.

Six of these 7 patients were CYP2C19*2 positive.

The scientists prescribed Effient, an alternative antiplatelet drug to eligible patients in this group, and all responded nicely.

“The day is rapidly approaching” when physicians can determine in advance how patients will respond to antiplatelet therapy and select agents likely to be effective “rather than blindly administering Plavix as we do now,” Gurbel concluded.

Plavix is co-marketed by Sanofi-Aventis and Bristol-Meyers Squibb. It is the world’s second largest selling drug, with $4 plus billion in revenues last year. It enjoys patent protection until November, 2011.

Eli Lilly and Daiichi Sankyo co-developed Effient, which was recently approved in the EU and is edging toward FDA approval.