Article open access publication

Predictors of pretreatment CA125 at ovarian cancer diagnosis: a pooled analysis in the Ovarian Cancer Association Consortium

Cancer Causes & Control, Springer Nature, ISSN 1573-7225

Volume 28, 5, 2017

DOI:10.1007/s10552-016-0841-3, Dimensions: pub.1019891781, PMC: PMC5593071, PMID: 28050675,



  1. (1) Dana-Farber Cancer Institute, grid.65499.37
  2. (2) Harvard University, grid.38142.3c
  3. (3) Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital and Harvard Medical School, 221 Longwood Ave, 02115, Boston, MA, USA
  4. (4) Medical University of South Carolina, grid.259828.c
  5. (5) University of Calgary, grid.22072.35
  6. (6) Royal Alexandra Hospital, grid.416087.c
  7. (7) Peter MacCallum Cancer Centre, grid.1055.1
  8. (8) QIMR Berghofer Medical Research Institute, grid.1049.c
  9. (9) University of Sydney, grid.1013.3
  10. (10) Westmead Hospital, grid.413252.3
  11. (11) Flanders Institute for Biotechnology, grid.11486.3a
  12. (12) KU Leuven, grid.5596.f
  13. (13) Cedars-Sinai Medical Center, grid.50956.3f
  14. (14) Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
  15. (15) Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens Stiftung/Knappschaft GmbH, Essen, Germany
  16. (16) Aichi Cancer Center, grid.410800.d
  17. (17) Danish Cancer Society, grid.417390.8
  18. (18) Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  19. (19) Mayo Clinic, grid.66875.3a
  20. (20) Oregon Health & Science University, grid.5288.7
  21. (21) University of Copenhagen, grid.5254.6, KU
  22. (22) The Juliane Marie Centre, Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  23. (23) University of Glasgow, grid.8756.c


PURPOSE: Cancer antigen 125 (CA125) is a glycoprotein expressed by epithelial cells of several normal tissue types and overexpressed by several epithelial cancers. Serum CA125 levels are mostly used as an aid in the diagnosis of ovarian cancer patients, to monitor response to treatment and detect cancer recurrence. Besides tumor characteristics, CA125 levels are also influenced by several epidemiologic factors, such as age, parity, and oral contraceptive use. Identifying factors that influence CA125 levels in ovarian cancer patients could aid in the interpretation of CA125 values for individuals. METHODS: We evaluated predictors of pretreatment CA125 in 13 studies participating in the Ovarian Cancer Association Consortium. This analysis included a total of 5,091 women with invasive epithelial ovarian cancer with pretreatment CA125 measurements. We used probit scores to account for variability in CA125 between studies and linear regression to estimate the association between epidemiologic factors and tumor characteristics and pretreatment CA125 levels. RESULTS: In age-adjusted models, older age, history of pregnancy, history of tubal ligation, family history of breast cancer, and family history of ovarian cancer were associated with higher CA125 levels while endometriosis was associated with lower CA125 levels. After adjusting for tumor-related characteristics (stage, histology, grade), body mass index (BMI) higher than 30 kg/m2 was associated with 10% (95% CI 2, 19%) higher CA125 levels, while race (non-white vs. white) was associated with 15% (95% CI 4, 27%) higher CA125 levels. CONCLUSION: Our results suggest that high BMI and race may influence CA125 levels independent of tumor characteristics. Validation is needed in studies that use a single assay for CA125 measurement and have a diverse study population.


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