By s Vinall
The Washington Post
A common test for ovarian cancer may be less effective on Black and Native American patients, new research has found.
One of the two most common ways to test for ovarian cancer is to check for elevated levels of a protein called CA-125 in the patient’s blood, according to the American Cancer Society. But Black and Native American women are 23 percent less likely to have an elevated CA-125 level when diagnosed with ovarian cancer, according to the study.
The University of Pennsylvania research, published March 20 in JAMA Network Open, reviewed the de-identified medical information of more than 200,000 ovarian cancer patients between 2004 and 2020 stored in the U.S. National Cancer Database.
“Current guidelines may contribute to delayed ovarian cancer diagnoses among women of other races and ethnicities than White,” the study authors wrote.
The research that originally identified cancer antigen 125 (CA-125) as a telltale sign of ovarian cancer may have been performed on mostly White patients, though the race of the participants was not recorded, they added.
Alistair Forrest, head of genome biology and genetic diseases at the Harry Perkins Institute of Medical Research in Western Australia, who was not involved in the study, said in an email that the research added to similar previous findings such as those published in a U.K. study last year.
The University of Pennsylvania study is “important as it recognizes that not everyone is the same and that a test that works in one population may not be useful in another,” said Forrest, who researches ovarian cancer.
The study adds to past research that has found differences in health outcomes for ovarian cancer among different racial groups. There are “profound disparities” in ovarian cancer recovery depending on the race of the patient, according to a summary of findings from the 2023 Ovarian Cancer Evidence Review Conference.
The review said that ovarian cancer was most common in Native American and White women but that Black patients were about 18 percent more likely to die of ovarian cancer than White women. There was no difference in mortality outcomes between Hispanic and White patients or Asian and Pacific Islander and White patients, it found.
It said the quality of care provided to each group could be a possible cause of the increased death rate and also noted that Black women were more likely to be diagnosed when the cancer was already at an advanced stage.
Ovarian cancer is the fifth most common cause of cancer death in women in the United States and has an overall 5-year survival rate of slightly less than half, the review noted. Survival is strongly correlated with early detection, it added.
The University of Pennsylvania study called for the development of more inclusive CA-125 thresholds and diagnostic guidelines, and for more research to understand why there could be differences in the CA-125 protein among different demographics.
The other most common way of testing for ovarian cancer is a transvaginal ultrasound, which detects unusual masses, according to the American Cancer Society. It notes that “not everyone who has ovarian cancer has a high CA-125 level.”
In its early stages, ovarian cancer often causes no symptoms, or symptoms that are easy to attribute to less serious conditions such as bloating, abdominal and pelvic pain, trouble eating and the need to urinate more frequently, the organization says. “If you have these symptoms more than 12 times a month, see your doctor,” it recommends.
