CA125 test result, test-to-diagnosis interval, and stage in ovarian cancer at diagnosis: a retrospective cohort study using electronic health records

Background In the UK, cancer antigen 125 (CA125) test is recommended as a first-line investigation in women with symptoms of possible ovarian cancer. Aim To compare time between initial primary care CA125 and diagnosis, tumour morphology, stage normal (<35 U/ml) abnormal (?35 levels prior to diagnosis. Design setting Retrospective cohort study using English registry data. Method Associations results test-to-diagnosis interval, stage, morphology were examined. Results total, 456 diagnosed 12 months after having test. Of these, 351 (77%) had an abnormal, 105 (23%) normal, result. The median interval was 35 days (interquartile range [IQR] 21–53) for those levels, 64 (IQR 42–127) levels. Tumour differed by result: indolent borderline tumours less common ( n = 47, 13%) than 51, 49%) P <0.001). Staging data available 304 77 35% 106) at early compared 86% 66) odds being early-stage disease higher opposed (odds ratio 12.2, 95% confidence 5.8 25.1, Conclusion Despite longer intervals testing more frequently commonly course disease. Although approaches that have greater sensitivity might expedite diagnosis some women, it not known if this would translate earlier-stage