National Cancer Database analysis of cancer antigen125 levels at time of ovarian cancer diagnosis by race and ethnicity

Multinational guidelines use cancer antigen (CA) 125 thresholds to recommend which patients with pelvic masses should undergo evaluation for ovarian cancer. However, CA-125 thresholds were developed from studies in White populations. A cohort study using the National Cancer Database investigated CA-125 levels at time of ovarian cancer diagnosis by race and ethnicity. In this study or 212,477 patients with measiured CA-125 levels, Black patients had significantly lower odds of having an elevated CA-125 level at ovarian cancer diagnosis compared with White patients, after adjusting for stage, comorbidities, and menopausal status. Patients with false-negative CA-125 findings started chemotherapy 9 days later than patients with elevated CA-125 levels. The authors conclude that these findings suggest that current CA-125 thresholds may miss Black patients with ovarian cancer and may delay treatment.