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Predicting circulating CA125 levels among healthy premenopausal women

Sasamoto, Naoko; Babic, Ana; Rosner, Bernard A.; Fortner, Renee T.; Vitonis, Allison F.; Yamamoto, Hidemi; Fichorova, Raina N.; Tjønneland, Anne; Hansen, Louise and Overvad, Kim, et al. (2019) In Cancer Epidemiology Biomarkers and Prevention 28(6). p.1076-1085
Abstract

Background: Cancer antigen 125 (CA125) is the most promising ovarian cancer screening biomarker to date. Multiple studies reported CA125 levels vary by personal characteristics, which could inform personalized CA125 thresholds. However, this has not been well described in premenopausal women. Methods: We evaluated predictors of CA125 levels among 815 premenopausal women from the New England Case Control Study (NEC). We developed linear and dichotomous (-35 U/mL) CA125 prediction models and externally validated an abridged model restricting to available predictors among 473 premenopausal women in the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Results: The final linear CA125 prediction model included age,... (More)

Background: Cancer antigen 125 (CA125) is the most promising ovarian cancer screening biomarker to date. Multiple studies reported CA125 levels vary by personal characteristics, which could inform personalized CA125 thresholds. However, this has not been well described in premenopausal women. Methods: We evaluated predictors of CA125 levels among 815 premenopausal women from the New England Case Control Study (NEC). We developed linear and dichotomous (-35 U/mL) CA125 prediction models and externally validated an abridged model restricting to available predictors among 473 premenopausal women in the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Results: The final linear CA125 prediction model included age, race, tubal ligation, endometriosis, menstrual phase at blood draw, and fibroids, which explained 7% of the total variance of CA125. The correlation between observed and predicted CA125 levels based on the abridged model (including age, race, and menstrual phase at blood draw) had similar correlation coefficients in NEC (r = 0.22) and in EPIC (r= 0.22). The dichotomous CA125 prediction model included age, tubal ligation, endometriosis, prior personal cancer diagnosis, family history of ovarian cancer, number of miscarriages, menstrual phase at blood draw, and smoking status with AUC of 0.83. The abridged dichotomous model (including age, number of miscarriages, menstrual phase at blood draw, and smoking status) showed similar AUCs in NEC (0.73) and in EPIC (0.78). Conclusions: We identified a combination of factors associated with CA125 levels in premenopausal women. Impact: Our model could be valuable in identifying healthy women likely to have elevated CA125 and consequently improve its specificity for ovarian cancer screening.

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Cancer Epidemiology Biomarkers and Prevention
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28
issue
6
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10 pages
publisher
American Association for Cancer Research
external identifiers
  • scopus:85067215131
ISSN
1055-9965
DOI
10.1158/1055-9965.EPI-18-1120
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English
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yes
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4e7266cb-2f70-42de-a179-2a7be8896589
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2019-07-01 10:16:24
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2019-07-16 04:13:40
@article{4e7266cb-2f70-42de-a179-2a7be8896589,
  abstract     = {<p>Background: Cancer antigen 125 (CA125) is the most promising ovarian cancer screening biomarker to date. Multiple studies reported CA125 levels vary by personal characteristics, which could inform personalized CA125 thresholds. However, this has not been well described in premenopausal women. Methods: We evaluated predictors of CA125 levels among 815 premenopausal women from the New England Case Control Study (NEC). We developed linear and dichotomous (-35 U/mL) CA125 prediction models and externally validated an abridged model restricting to available predictors among 473 premenopausal women in the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Results: The final linear CA125 prediction model included age, race, tubal ligation, endometriosis, menstrual phase at blood draw, and fibroids, which explained 7% of the total variance of CA125. The correlation between observed and predicted CA125 levels based on the abridged model (including age, race, and menstrual phase at blood draw) had similar correlation coefficients in NEC (r = 0.22) and in EPIC (r= 0.22). The dichotomous CA125 prediction model included age, tubal ligation, endometriosis, prior personal cancer diagnosis, family history of ovarian cancer, number of miscarriages, menstrual phase at blood draw, and smoking status with AUC of 0.83. The abridged dichotomous model (including age, number of miscarriages, menstrual phase at blood draw, and smoking status) showed similar AUCs in NEC (0.73) and in EPIC (0.78). Conclusions: We identified a combination of factors associated with CA125 levels in premenopausal women. Impact: Our model could be valuable in identifying healthy women likely to have elevated CA125 and consequently improve its specificity for ovarian cancer screening.</p>},
  author       = {Sasamoto, Naoko and Babic, Ana and Rosner, Bernard A. and Fortner, Renee T. and Vitonis, Allison F. and Yamamoto, Hidemi and Fichorova, Raina N. and Tjønneland, Anne and Hansen, Louise and Overvad, Kim and Kvaskoff, Marina and Fournier, Agnes and Mancini, Francesca Romana and Boeing, Heiner and Trichopoulou, Antonia and Peppa, Eleni and Karakatsani, Anna and Palli, Domenico and Pala, Valeria and Mattiello, Amalia and Tumino, Rosario and Grasso, Chiara C. and Onland-Moret, N. Charlotte and Weiderpass, Elisabete and Quiros, J. Ramon and Lujan-Barroso, Leila and Rodríguez-Barranco, Miguel and Colorado-Yohar, Sandra and Barricarte, Aurelio and Dorronsoro, Miren and Idahl, Annika and Lundin, Eva and Sartor, Hanna and Khaw, Kay Tee and Key, Timothy J. and Muller, David and Riboli, Elio and Gunter, Marc J. and Dossus, Laure and Kaaks, Rudolf and Cramer, Daniel W. and Tworoger, Shelley S. and Terry, Kathryn L.},
  issn         = {1055-9965},
  language     = {eng},
  number       = {6},
  pages        = {1076--1085},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer Epidemiology Biomarkers and Prevention},
  title        = {Predicting circulating CA125 levels among healthy premenopausal women},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-18-1120},
  volume       = {28},
  year         = {2019},
}