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dc.contributor.authorFunston, G
dc.contributor.authorMounce, LT
dc.contributor.authorPrice, S
dc.contributor.authorRous, B
dc.contributor.authorCrosbie, EJ
dc.contributor.authorHamilton, W
dc.contributor.authorWalter, FM
dc.date.accessioned2022-06-27T07:58:33Z
dc.date.issued2021-05-27
dc.date.updated2022-06-24T17:55:15Z
dc.description.abstractBACKGROUND: In the UK, the 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 test and diagnosis, tumour morphology, and stage in women with normal (<35 U/ml) and abnormal (≥35 U/ml) CA125 levels prior to ovarian cancer diagnosis. DESIGN AND SETTING: Retrospective cohort study using English primary care and cancer registry data. METHOD: Associations between CA125 test results and test-to-diagnosis interval, stage, and ovarian cancer morphology were examined. RESULTS: In total, 456 women were diagnosed with ovarian cancer in the 12 months after having a CA125 test. Of these, 351 (77%) had an abnormal, and 105 (23%) had a normal, CA125 test result. The median test-to-diagnosis interval was 35 days (interquartile range [IQR] 21-53) for those with abnormal CA125 levels, and 64 days (IQR 42-127) for normal CA125 levels. Tumour morphology differed by CA125 result: indolent borderline tumours were less common in those with abnormal CA125 levels (n = 47, 13%) than those with normal CA125 levels (n = 51, 49%) (P<0.001). Staging data were available for 304 women with abnormal, and 77 with normal, CA125 levels. Of those with abnormal CA125 levels, 35% (n = 106) were diagnosed at an early stage, compared to 86% (n = 66) of women with normal levels. The odds of being diagnosed with early-stage disease were higher in women with normal as opposed to abnormal CA125 levels (odds ratio 12.2, 95% confidence interval = 5.8 to 25.1, P<0.001). CONCLUSION: Despite longer intervals between testing and diagnosis, women with normal, compared with abnormal, CA125 levels more frequently had indolent tumours and were more commonly diagnosed at an early stage in the course of the disease. Although testing approaches that have greater sensitivity might expedite diagnosis for some women, it is not known if this would translate to earlier-stage diagnosis.en_GB
dc.description.sponsorshipCancer Research UKen_GB
dc.description.sponsorshipNational Institute for Health Research (NIHR)en_GB
dc.format.extente465-e472
dc.format.mediumElectronic-Print
dc.identifier.citationVol. 71(707), pp. e465-e472en_GB
dc.identifier.doihttps://doi.org/10.3399/BJGP.2020.0859
dc.identifier.grantnumberC8640/A23385en_GB
dc.identifier.grantnumberFR17 424en_GB
dc.identifier.grantnumberIS-BRC-1215-20007en_GB
dc.identifier.urihttp://hdl.handle.net/10871/130059
dc.identifierORCID: 0000-0002-6089-0661 (Mounce, Luke Ta)
dc.identifierORCID: 0000-0002-2228-2374 (Price, Sarah)
dc.identifierScopusID: 57195915869 (Price, Sarah)
dc.identifierResearcherID: D-2641-2016 (Price, Sarah)
dc.identifierORCID: 0000-0003-1611-1373 (Hamilton, Willie)
dc.identifierScopusID: 55031252700 | 57209301809 (Hamilton, Willie)
dc.identifierResearcherID: G-8612-2014 (Hamilton, Willie)
dc.language.isoenen_GB
dc.publisherRoyal College of General Practitionersen_GB
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pubmed/33875416en_GB
dc.rights© The Authors. This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/).en_GB
dc.subjectCA125en_GB
dc.subjectcancer antigen 125en_GB
dc.subjectdiagnostic intervalsen_GB
dc.subjectearly diagnosisen_GB
dc.subjectgeneral practiceen_GB
dc.subjectovarian canceren_GB
dc.subjectCA-125 Antigenen_GB
dc.titleCA125 test result, test-to-diagnosis interval, and stage in ovarian cancer at diagnosis: a retrospective cohort study using electronic health recordsen_GB
dc.typeArticleen_GB
dc.date.available2022-06-27T07:58:33Z
dc.identifier.issn0960-1643
exeter.place-of-publicationEngland
dc.descriptionThis is the final version. Available on open access from the Royal College of General Practitioners via the DOI in this recorden_GB
dc.identifier.eissn1478-5242
dc.identifier.journalBritish Journal of General Practiceen_GB
dc.relation.ispartofBr J Gen Pract, 71(707)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_GB
dcterms.dateAccepted2020-12-02
dc.rights.licenseCC BY
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2021-05-27
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2022-06-26T13:40:08Z
refterms.versionFCDVoR
refterms.dateFOA2022-06-27T08:00:34Z
refterms.panelAen_GB
refterms.dateFirstOnline2021-05-27


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© The Authors.
This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/).
Except where otherwise noted, this item's licence is described as © The Authors. This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/).