scholarly journals Multi-Marker Longitudinal Algorithms Incorporating HE4 and CA125 in Ovarian Cancer Screening of Postmenopausal Women

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1931
Author(s):  
Aleksandra Gentry-Maharaj ◽  
Oleg Blyuss ◽  
Andy Ryan ◽  
Matthew Burnell ◽  
Chloe Karpinskyj ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Area Under The Curve ◽  
Serum Samples ◽  
Ovarian Cancer Screening ◽  
Serum Ca125 ◽  
Line Test ◽  
Validation Set ◽  
Serial Samples

Longitudinal CA125 algorithms are the current basis of ovarian cancer screening. We report on longitudinal algorithms incorporating multiple markers. In the multimodal arm of United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), 50,640 postmenopausal women underwent annual screening using a serum CA125 longitudinal algorithm. Women (cases) with invasive tubo-ovarian cancer (WHO 2014) following outcome review with stored annual serum samples donated in the 5 years preceding diagnosis were matched 1:1 to controls (no invasive tubo-ovarian cancer) in terms of the number of annual samples and age at randomisation. Blinded samples were assayed for serum human epididymis protein 4 (HE4), CA72-4 and anti-TP53 autoantibodies. Multimarker method of mean trends (MMT) longitudinal algorithms were developed using the assay results and trial CA125 values on the training set and evaluated in the blinded validation set. The study set comprised of 1363 (2–5 per woman) serial samples from 179 cases and 181 controls. In the validation set, area under the curve (AUC) and sensitivity of longitudinal CA125-MMT algorithm were 0.911 (0.871–0.952) and 90.5% (82.5–98.6%). None of the longitudinal multi-marker algorithms (CA125-HE4, CA125-HE4-CA72-4, CA125-HE4-CA72-4-anti-TP53) performed better or improved on lead-time. Our population study suggests that longitudinal HE4, CA72-4, anti-TP53 autoantibodies adds little value to longitudinal serum CA125 as a first-line test in ovarian cancer screening of postmenopausal women.

scholarly journals Performance of ultrasound as a second line test to serum CA125 in ovarian cancer screening

2014 ◽  
Vol 121 ◽  
pp. 35-39 ◽  
Author(s):  
Usha Menon ◽  
Ahmed Talaat ◽  
Adam N. Rosenthal ◽  
Nicola D. Macdonald ◽  
Arjun R. Jeyerajah ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Second Line ◽  
Ovarian Cancer Screening ◽  
Serum Ca125 ◽  
Line Test

Performance of ultrasound as a second line test to serum CA125 in ovarian cancer screening

2000 ◽  
Vol 107 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Usha Menon ◽  
Ahmed Talaat ◽  
Adam N. Rosenthal ◽  
Nicola D. Macdonald ◽  
Arjun R. Jeyerajah ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Second Line ◽  
Ovarian Cancer Screening ◽  
Serum Ca125 ◽  
Line Test

Ovarian cancer screening in asymptomatic postmenopausal women by transvaginal sonography

Cancer ◽  
1991 ◽  
Vol 68 (3) ◽  
pp. 458-462 ◽  
Author(s):  
J. R. Van Nagell ◽  
P. D. Depriest ◽  
L. E. Puls ◽  
E. S. Donaldson ◽  
H. H. Gallion ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Transvaginal Sonography ◽  
Ovarian Cancer Screening

91341916 Ovarian cancer screening in asymptomatic postmenopausal women by transviginal sonography

Maturitas ◽  
1992 ◽  
Vol 15 (1) ◽  
pp. 87
Author(s):  
J.R Van Nagell ◽  
P.D DePriest ◽  
L.E Puls ◽  
E.S Donaldson ◽  
H.H Gallion ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Ovarian Cancer Screening

Ovarian Cancer Screening in Asymptomatic Postmenopausal Women

1993 ◽  
Vol 51 (2) ◽  
pp. 205-209 ◽  
Author(s):  
P.D. DePriest ◽  
J.R. van Nagell ◽  
H.H. Gallion ◽  
D. Shenson ◽  
J.E. Hunter ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Ovarian Cancer Screening

scholarly journals Development and validation of circulating CA125 prediction models in postmenopausal women

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Naoko Sasamoto ◽  
Ana Babic ◽  
Bernard A. Rosner ◽  
Renée T. Fortner ◽  
Allison F. Vitonis ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Prediction Model ◽  
Postmenopausal Women ◽  
Prediction Models ◽  
Smoking Status ◽  
Large Population ◽  
External Validation ◽  
Validation Dataset ◽  
Ovarian Cancer Screening

Abstract Background Cancer Antigen 125 (CA125) is currently the best available ovarian cancer screening biomarker. However, CA125 has been limited by low sensitivity and specificity in part due to normal variation between individuals. Personal characteristics that influence CA125 could be used to improve its performance as screening biomarker. Methods We developed and validated linear and dichotomous (≥35 U/mL) circulating CA125 prediction models in postmenopausal women without ovarian cancer who participated in one of five large population-based studies: Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO, n = 26,981), European Prospective Investigation into Cancer and Nutrition (EPIC, n = 861), the Nurses’ Health Studies (NHS/NHSII, n = 81), and the New England Case Control Study (NEC, n = 923). The prediction models were developed using stepwise regression in PLCO and validated in EPIC, NHS/NHSII and NEC. Result The linear CA125 prediction model, which included age, race, body mass index (BMI), smoking status and duration, parity, hysterectomy, age at menopause, and duration of hormone therapy (HT), explained 5% of the total variance of CA125. The correlation between measured and predicted CA125 was comparable in PLCO testing dataset (r = 0.18) and external validation datasets (r = 0.14). The dichotomous CA125 prediction model included age, race, BMI, smoking status and duration, hysterectomy, time since menopause, and duration of HT with AUC of 0.64 in PLCO and 0.80 in validation dataset. Conclusions The linear prediction model explained a small portion of the total variability of CA125, suggesting the need to identify novel predictors of CA125. The dichotomous prediction model showed moderate discriminatory performance which validated well in independent dataset. Our dichotomous model could be valuable in identifying healthy women who may have elevated CA125 levels, which may contribute to reducing false positive tests using CA125 as screening biomarker.

Ovarian Cancer Screening in Asymptomatic Postmenopausal Women

1994 ◽  
Vol 49 (5) ◽  
pp. 330-331
Author(s):  
P. D. DePriest ◽  
J. R. van Nagell ◽  
H. H. Gallion ◽  
D. Shenson ◽  
J. E. Hunter ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Ovarian Cancer Screening

A randomized study of screening for ovarian cancer: a multicenter study in Japan

2008 ◽  
Vol 18 (3) ◽  
pp. 414-420 ◽  
Author(s):  
H. Kobayashi ◽  
Y. Yamada ◽  
T. Sado ◽  
M. Sakata ◽  
S. Yoshida ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Statistical Significance ◽  
Intervention Group ◽  
Developed Countries ◽  
Control Group ◽  
Ovarian Cancer Screening ◽  
Gynecological Examination

Ovarian cancer is common in women from developed countries. We designed a prospective randomized controlled trial of ovarian cancer screening to establish an improved strategy for the early detection of cancers. Asymptomatic postmenopausal women were randomly assigned between 1985 and 1999 to either an intervention group (n= 41,688) or a control group (n= 40,799) in a ratio of 1:1, with follow-up of mean 9.2 years, in Shizuoka district, Japan. The original intention was to offer women in the intervention group annual screens by gynecological examination (sequential pelvic ultrasound [US] and serum CA125 test). Women with abnormal US findings and/or raised CA125 values were referred for surgical investigation by a gynecological oncologist. In December 2002, the code was broken and the Shizuoka Cohort Study of Ovarian Cancer Screening and Shizuoka Cancer Registry were searched to determine both malignant and nonmalignant diagnoses. Twenty-seven cancers were detected in the 41,688-screened women. Eight more cancers were diagnosed outside the screening program. Detection rates of ovarian cancer were 0.31 per 1000 at the prevalent screen and 0.38–0.74 per 1000 at subsequent screens; they increased with successive screening rounds. Among the 40,779 control women, 32 women developed ovarian cancer. The proportion of stage I ovarian cancer was higher in the screened group (63%) than in the control group (38%), which did not reach statistical significance (P= 0.2285). This is to our knowledge the first prospective randomized report of the ovarian cancer screening. The rise in the detection of early-stage ovarian cancer in asymptomatic postmenopausal women is not significant, but future decisions on screening policy should be informed by further follow-up from this trial.

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