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Researchers have found a way to detect an early warning sign of advanced ovarian cancer which is typically invisible to normal imaging methods.
Experts at Hoag Memorial Hospital Presbyterian found that one blood marker could help clinicians identify whether a patient has serous tubal intraepithelial carcinoma, a microscopic, non-invasive lesion that develops in the lining of the fallopian tube, which is an early sign of high-grade serous ovarian cancer.
The finding could have significant implications for ovarian cancer screening. The cancer is often diagnosed in its more advanced stages as it is very difficult to detect—only around 20 percent of ovarian cancers are found at an early stage, according to the American Cancer Society.
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The cancer does not usually cause symptoms until it is in its more advanced stages, and normal imaging methods are not usually able to detect small tumors on the ovaries. This means detection can happen when the cancer has already spread.
This finding could therefore be particularly meaningful for women at higher risk of ovarian cancer, enabling earlier detection, while also transforming prevention, the researchers said.
The study was published in the journal Nature Medicine on November 10.
"I think these are very exciting and potentially transformative findings," Dr Ronny Drapkin, director of the Penn Ovarian Cancer Research Center at the University of Pennsylvania, who was not involved in the study, told Newsweek. "What makes this study particularly compelling is that Tu-stroma appears to be detectable at the very earliest recognizable stages of ovarian cancer development."
He also said that this study "beautifully illustrates why fundamental research is so important," as by "studying how cancer cells interact with their surrounding environment, the investigators uncovered an unexpected opportunity for early detection."
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What Is Tu-Stroma?
When cancer develops, it has to find space within the body to grow—space that is already occupied by healthy cells, study author Esha Madan, a scientist at Hoag Family Cancer Institute, told Newsweek.
For the case of ovarian cancer cells, Madan and the team found that the cells "can actively influence the healthy cells surrounding them," so rather than "simply growing into available space, cancer cells can send molecular messages that weaken their healthy neighbors, making it easier for cancer to establish itself and expand."
"One of these molecular messages is a long non-coding RNA molecule that we discovered and named Tu-stroma," she added.
What they found happened is cancer cells can package Tu-stroma into "tiny membrane-enclosed particles called extracellular vesicles, which act as delivery vehicles between cells," Madan said, and when this "molecular message reaches neighboring healthy cells, it can influence a biological system that determines how cells recognize and respond to differences in their competitive fitness."
She added that this means cancer can "make the surrounding healthy tissue biologically weaker so that it can become stronger."
What The Study Found
The researchers found the women with serous tubal intraepithelial carcinoma or high-grade serous ovarian cancer had elevated levels of an RNA molecule called Tu-stroma in their blood.
For serous tubal intraepithelial carcinoma, the abnormal cells are "still confined to the lining of the fallopian tube," Madan said.
"There may be no visible tumor, no symptoms, and no indication through conventional blood testing that such an early lesion exists," but, due to the Tu-stroma discovery, they were able to detect a "molecular signal associated with this biological process in blood," which is what "makes this discovery so exciting," she continued.
"Instead of waiting for cancer to become a substantial tumor, we may eventually be able to detect the molecular messages associated with its earliest development," she added.
To validate the findings, researchers then found that a blood test to measure Tu-stroma was able to detect precancerous cases in around 92 percent of women who had serous tubal intraepithelial carcinoma, while also accurately identifying 98 percent of women without the condition.
When modelling the results in a high-risk population, the experts found the test could have the potential to detect 72 percent of positive cases, while identifying negative results accurately almost every time.
"Another encouraging observation was that Tu-stroma performed well in pre-menopausal women, including comparisons with women who had benign gynecological conditions," Madan said.
They also noticed that Tu-stroma levels did not significantly increase as the cancer progressed into its more advanced stages, which Madan said "suggests that we may be observing a biological program that becomes active very early in cancer development, rather than simply measuring the amount of established tumor."
What This Means For Patients
"I believe the most important implication is that the earliest warning signs of ovarian cancer may be detectable in blood while the disease is still microscopic and non-invasive," Madan said. "That possibility is particularly important because ovarian cancer remains one of the most challenging cancers to identify early."
She said that many women experience "no recognizable symptoms during the earliest stages of disease," and by the time symptoms develop and a diagnosis is made, the cancer may "already have spread beyond its original location."
Also for women who have an increased risk of ovarian cancer, they may be advised to undergo preventive removal of fallopian tubes and ovaries, even though they have no known cancer, Madan explained.
"This can be a lifesaving intervention, but for a younger woman it can also mean loss of natural fertility, immediate surgical menopause, and significant consequences for hormonal health and quality of life," she said.
Drapkin also said that this test "could be especially important for women who carry inherited BRCA1 or BRCA2 mutations and face a substantially increased risk of ovarian cancer," as a "reliable blood test could eventually provide an important new tool for monitoring these women."
However, he emphasized that the test is "not yet ready for clinical use," and that these findings "need to be confirmed in larger studies that follow women over time to determine whether the test can detect cancer before symptoms appear."
"Our discovery opens the possibility of investigating a fundamentally different approach: identifying a biological signal associated with cancer development before conventional invasive disease has emerged," Madan added.
She said the team is now working on pushing the research into prospective clinical evaluation, by preparing to initiate prospective studies at Hoag Family Cancer Institute in Newport Beach, California, where women will be able to participate in the next phase of investigating this blood-based molecular marker.
Reference
Wilhelm, J., Kumar, A., Vasiyani, H. et al. (2026) Blood-based RNA biomarker for the early detection of ovarian cancer. Nature Medicine. https://doi.org/10.1038/s41591-026-04732-9
Contact Newsweek editors on this story: Kara Dolman and Paul Donnelley.
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