Med Tech-related health technology assessments from NIHR in March 2025

The National Institute for Health and Care Research (NIHR) funds valuable independent research for health and social care decision-makers in England. Reports from the Health Technology Assessment (HTA) Programme are published in the NIHR HTA Journal and inform the National Institute for Health and Care Excellence (NICE) guidance. 

In March 2025, four Med Tech-related assessments were published in the NIHR HTA Journal:

• Association of hysterectomy and invasive epithelial ovarian and tubal cancer based on the prospective cohort study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Multivariable analysis revealed no evidence linking hysterectomy to an increased risk of invasive epithelial ovarian or tubal cancer. This finding was further corroborated by a large cohort study, confirming that hysterectomy does not impact the risk of developing invasive epithelial ovarian and tubal cancers. These findings are vital for clinical counseling and the enhancement of risk prediction models.
• Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) based on a randomized controlled trial in which postmenopausal women aged 50–74 years were randomized to annual multimodal screening (MMS), which included serum CA125 measurements, with the pattern over time interpreted using the risk of ovarian cancer (ROCA) calculation, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The findings indicated that the decrease in the incidence of stage III or IV disease within the MMS group was not substantial enough to result in lives saved. This highlights the necessity of prioritizing cancer mortality as the primary outcome in screening trials. Since screening did not lead to a significant reduction in deaths from ovarian and tubal cancer, it cannot be recommended for the general population.
• Serial endometrial thickness and risk of non-endometrial hormone-dependent cancers in postmenopausal women in UK Collaborative Trial of Ovarian Cancer Screening based on the cohort study nested within the UKCTOCS. The endometrial thickness (ET) assessed through transvaginal ultrasound (TVS) reflects estrogen-induced endometrial proliferation, which is a recognized risk factor for multiple cancers. This study sought to investigate the relationship between baseline and serial ET measurements and nine types of non-endometrial hormone-sensitive cancers in postmenopausal women. The findings indicated that postmenopausal women with elevated or increasing ET on TVS have a higher risk of developing breast, ovarian, and lung cancer. Clinicians should consider these associated risks because TVS is a standard diagnostic procedure.
• Performance Characteristics of the Ultrasound Strategy during Incidence Screening in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Transvaginal ultrasonography (TVS) is considered the sole primary screening test in the ultrasound arm (USS) of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). The findings indicate that the combination of low sensitivity and the late stage at which interval cancers are detected raises doubts about the appropriateness of using ultrasound scanning as a first-line screening method for ovarian cancer in population settings.

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