A commonly used ovarian cancer test may only be appropriate for white people

Embargoed until: Publicly released: 2025-03-21 12:03

International

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International guidelines use cancer antigen (CA) 125 thresholds in blood to recommend which patients with pelvic masses should be evaluated by gynaecological cancer specialists to check for ovarian cancer. However, these thresholds are based on data from white populations only, and different threshold levels should be developed for non-white people, according to a US study. The team looked at data on 212,477 patients whose CA-125 levels had been measured, and found American Indian and Black patients were 23% less likely than white patients to have an elevated CA-125 level when they were diagnosed with ovarian cancer. So, some ovarian cancer cases would have been missed when this test was used in these populations. Further work should be undertaken to develop new CA-125 thresholds and guidelines for more inclusive ovarian cancer diagnosis, the researchers conclude.

Media release

From: JAMA

Cancer Antigen 125 Levels at Time of Ovarian Cancer Diagnosis by Race and Ethnicity

About The Study: In this cohort study of patients with ovarian cancer, American Indian and Black patients were 23% less likely to have an elevated cancer antigen (CA)-125 level at diagnosis. Current CA-125 thresholds may miss racially and ethnically diverse patients with ovarian cancer. International guidelines use CA-125 thresholds to recommend which patients with pelvic masses should undergo evaluation by gynecologic oncologists for ovarian cancer. However, CA-125 thresholds were developed from white populations. Work is needed to develop inclusive CA-125 thresholds and diagnostic guidelines and not compound disparities in ovarian cancer diagnosis and treatment.

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Research JAMA, Web page

Journal/
conference: JAMA Network Open

Research:Paper

Organisation/s: University of Pennsylvania, USA

Funder: This project was support by career enhancement grant 2P50CA228991-06A1 from the National Cancer Institute Ovarian Cancer Specialized Programs of Research Excellence (Drs Smith, Howell, and McCarthy) and Paul Calabresi Career Development for Clinical Oncology award 5K12CA076931-25 from the National Cancer Institute (Dr Smith).

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