JAMA Netw Open
Ovarian cancer screening test fails to detect cases in certain racial groups
Current cancer antigen (CA) 125 thresholds may not be inclusive of racially and ethnically diverse populations, potentially leading to delayed ovarian cancer diagnoses and treatment in these groups. There's a need to develop more inclusive CA-125 thresholds and diagnostic guidelines to avoid exacerbating disparities in ovarian cancer diagnosis and treatment.
Study design: This retrospective cohort study analyzed data from the U.S. National Cancer Database, including 250,749 patients diagnosed with ovarian cancer between January 1, 2004, and December 31, 2020. The study aimed to examine CA-125 levels at diagnosis by race and ethnicity and their association with timely treatment initiation.
Results: 88.2% of the 212,477 patients with measured CA-125 levels had elevated levels at diagnosis. However, American Indian, Asian, and Black patients were less likely to have elevated CA-125 levels compared with White patients. Specifically, Black patients had lower odds of elevated CA-125 levels (adjusted odds ratio [AOR], 0.77; 95% confidence interval [CI], 0.74-0.81), as did American Indian patients (AOR, 0.77; 95% CI, 0.62-0.94). Among patients with high-grade serous ovarian cancer, Black patients had a lower odds of elevated CA-125 levels (AOR, 0.81; 95% CI, 0.73-0.91). Patients with stage II to IV ovarian cancer and false-negative CA-125 findings had a 9.38-day longer delay to chemotherapy initiation compared with those with elevated CA-125 levels.
Source:
Smith AJB, et al. (2025, March 3). JAMA Netw Open. Cancer Antigen 125 Levels at Time of Ovarian Cancer Diagnosis by Race and Ethnicity. https://pubmed.ncbi.nlm.nih.gov/40111363/