TY - JOUR
T1 - CA125 test result, test-to-diagnosis interval and stage in ovarian cancer: a cohort study using electronic health records
AU - Funston, Garth
AU - Mounce, Luke
AU - Price, Sarah
AU - Rous, Brian
AU - Crosbie, Emma
AU - Hamilton, Willie
AU - Walter, Fiona M.
PY - 2020/12/2
Y1 - 2020/12/2
N2 - Background
Cancer-Antigen-125 (CA125) is recommended as a first-line investigation in women in UK
General Practice with symptoms of possible ovarian cancer.
Aim
To compare time between initial primary care CA125 test and diagnosis (test-to-diagnosis
interval), tumour morphology and stage, in women with normal (<35U/ml) and abnormal
(≥35U/ml) CA125 prior to ovarian cancer diagnosis.
Design
Retrospective cohort study using routinely collected primary care and cancer registry data.
Methods
Associations between CA125 result with test-to-diagnosis interval, stage and ovarian cancer
morphology were examined.
Results
351 (77%) women had an abnormal and 105 (23%) a normal initial CA125 result prior to
ovarian cancer diagnosis. Median test-to-diagnosis interval was 35 days (Interquartile range
[IQR]:21-53) in those with abnormal, and 64 days (IQR:42-127) in those with normal CA125s.
Tumour morphology differed by CA125 result, with indolent borderline tumours being less
common in those with abnormal (n=47, 13%) than normal (n=51, 49%) CA125s (p<0.001).
Staging data was available for 381 women. 106 of 304 (35%) women with abnormal CA125s
and 66 of 77 (86%) women with normal CA125s were diagnosed at an early stage: normal
CA125s were associated with early-stage diagnosis (Odds Ratio:12.1, 95% CI:5.8-25.1,
p<0.001).
Conclusion
Despite experiencing longer intervals between testing and diagnosis, women with normal
CA125s more frequently had indolent tumours and were more commonly diagnosed at an
early stage, compared to those with abnormal CA125s. Whilst more sensitive testing
approaches might expedite diagnosis for some women, it is not known whether this would
translate to earlier stage diagnosis and improved survival.
AB - Background
Cancer-Antigen-125 (CA125) is recommended as a first-line investigation in women in UK
General Practice with symptoms of possible ovarian cancer.
Aim
To compare time between initial primary care CA125 test and diagnosis (test-to-diagnosis
interval), tumour morphology and stage, in women with normal (<35U/ml) and abnormal
(≥35U/ml) CA125 prior to ovarian cancer diagnosis.
Design
Retrospective cohort study using routinely collected primary care and cancer registry data.
Methods
Associations between CA125 result with test-to-diagnosis interval, stage and ovarian cancer
morphology were examined.
Results
351 (77%) women had an abnormal and 105 (23%) a normal initial CA125 result prior to
ovarian cancer diagnosis. Median test-to-diagnosis interval was 35 days (Interquartile range
[IQR]:21-53) in those with abnormal, and 64 days (IQR:42-127) in those with normal CA125s.
Tumour morphology differed by CA125 result, with indolent borderline tumours being less
common in those with abnormal (n=47, 13%) than normal (n=51, 49%) CA125s (p<0.001).
Staging data was available for 381 women. 106 of 304 (35%) women with abnormal CA125s
and 66 of 77 (86%) women with normal CA125s were diagnosed at an early stage: normal
CA125s were associated with early-stage diagnosis (Odds Ratio:12.1, 95% CI:5.8-25.1,
p<0.001).
Conclusion
Despite experiencing longer intervals between testing and diagnosis, women with normal
CA125s more frequently had indolent tumours and were more commonly diagnosed at an
early stage, compared to those with abnormal CA125s. Whilst more sensitive testing
approaches might expedite diagnosis for some women, it is not known whether this would
translate to earlier stage diagnosis and improved survival.
M3 - Article
JO - British Journal of General Practice
JF - British Journal of General Practice
SN - 0960-1643
ER -