Ethnic Disparity in Clinical Performance Between Multivariate Index Assay and CA125 in Detection of Ovarian Malignancy

Abstract

Aim: Based on evidence that African–American (AA) women have lower CA125 values than Caucasian (C) women, we investigated this to see if this disparity would have an impact on ovarian cancer detection using CA125 and multivariate index assay (MIA). Materials & methods: Serum from two prospective trials of 1029 (274 malignancies [250 C/24AA]) were analyzed for CA125 and MIA results. Clinical performance was calculated. Results: Sensitivity of MIA in Caucasian women was 93.2%, 74.4% for CA125 at the ACOG approved cut-off level of 200 U/ml cutoff, and 80.4% using the 2007, Dearking 67 U/ml cutoff. In AA American women, MIA sensitivity was 79.2%, 33.3% for CA125 at the ACOG approved cut-off levels and 62.5% at the 2007, Dearking 67 U/ml cutoff. Conclusion: Our results support that CA125 in AA women with adnexal masses has lower sensitivity than MIA no matter what the cutoff value is. Implementation of MIA in evaluation of adnexal masses should increase sensitivity of detection of malignancy compared with CA125, particularly in AA women.

Management of the Adnexal Mass: Considerations for the Family Medicine Physician

“…Evaluation of MIA across races demonstrated performance differences compared with CA125-II ( 47 ). A number of independent studies have shown that CA125-II levels are lower in non-Caucasian women ( 48 – 51 ).…”

“…These two factors could cause CA 125-II to underperform in non-Caucasian populations. Sensitivity of MIA in Black women was 79% compared to a sensitivity of 62% with CA 125-II using the Dearking modified cutoffs of 67 U/mL for premenopausal women and 35 U/mL for postmenopausal women ( 47 , 53 ). Similar data was seen in comparison to ROMA in Black women, with the sensitivity of ROMA at 54% ( 54 ).…”

Welcome to the 16th Volume of Future Oncology

“…• Our highest score was for the previously mentioned 'Sequential afatinib and osimertinib in patients with EGFR mutation-positive non-small-cell lung cancer: updated analysis of the observational GioTag study' -Altmetric score: 96 [3]. • We also received high scores for Toni Leigh Mortimer (Stellenbosch University, South Africa) and colleagues' review 'Cannabinoids: the lows and the highs of chemotherapy-induced nausea and vomiting' and Charles Dunton (Vermillion, TX, USA) and colleagues' original research article 'Ethnic disparity in clinical performance between multivariate index assay and CA125 in detection of ovarian malignancy' [8,9]. Altmetric scores: 68 and 53, respectively.…”

Knockdown of MUC16 (CA125) Enhances the Migration and Invasion of Hepatocellular Carcinoma Cells

“…As an unusual glycoprotein, the expression of MUC16 is mainly located in the cell membrane or scattered in bodily fluids as a soluble form ( 9 ). MUC16 has been extensively used as a biomarker for ovarian cancer, and its expression has been associated with disease progression and has proven valuable in both detection and disease monitoring ( 10 , 11 ). It has also been reported that rising concentrations of soluble CA125 were detected in breast cancer, mesothelioma, gastric cancer, colorectal adenocarcinoma, etc.…”