Physician Knowledge and Awareness of CA-125 as a Screen for Ovarian Cancer in the Asymptomatic, Average-Risk Population

Abstract

Effective early detection strategies for ovarian cancer do not exist. Current screening guidelines recommend against routine screening using CA-125 alone or in combination with transvaginal ultrasonography (TVS). In this study, the authors used the 2008 DocStyles survey to measure clinician beliefs about the effectiveness of CA-125 and TVS in the asymptomatic, average-risk population in the United States. To assess the need for provider education, the authors used the 2008 HealthStyles survey to examine public awareness of CA-125. Of 1,250 physician respondents, 40.4% said both CA-125 and TVS were effective screens, and 28.3% said neither was an effective ovarian cancer screen in the asymptomatic, average-risk population. Obstetrician/gynecologists [OB/GYNs] more often had responses consistent with current guidelines: 56.5% of OB/GYNs, compared with 34.4% and 29.8% of family/general practitioners and internists, respectively, said neither CA-125 nor TVS was an effective screen. Almost one third of women surveyed reported having heard of CA-125, and about one tenth said they had the CA-125 test. These findings support the need for additional provider education. Educational efforts should include lack of evidence for, as well as the potential harms of, screening for ovarian cancer with CA-125.

A National Initiative for Women and Healthcare Providers: CDC's Inside Knowledge: Get the Facts About Gynecologic Cancer Campaign

“…This study showed that about 25% of women reported having heard of the CA-125, with about 10% of women reporting having previously received a CA-125 blood test. 24 Characteristics of women who had not heard of or had the CA-125 blood test were similar to those who had, with the exception that those who had heard of it/had it were more often older and perimenopausal or postmenopausal. 24 Concern for getting ovarian cancer did not differ significantly among women who heard of/had the CA-125 test compared to those who had not heard of or had it.…”

“…24 Characteristics of women who had not heard of or had the CA-125 blood test were similar to those who had, with the exception that those who had heard of it/had it were more often older and perimenopausal or postmenopausal. 24 Concern for getting ovarian cancer did not differ significantly among women who heard of/had the CA-125 test compared to those who had not heard of or had it. 24 A third analysis from the same survey data examined self-reported intent to seek care for symptoms associated with ovarian cancer.…”

“…24 Concern for getting ovarian cancer did not differ significantly among women who heard of/had the CA-125 test compared to those who had not heard of or had it. 24 A third analysis from the same survey data examined self-reported intent to seek care for symptoms associated with ovarian cancer. The results showed that gynecologic symptoms (such as post-menopausal bleeding) prompted more intention to seek care than those that would be considered less gynecologic in nature but are, in fact, associated with ovarian cancer (e.g., feeling full after eating a small amount).…”

“…One thousand primary care physicians (510 family/general practitioners and 490 internists) and 250 obstetrician/ gynecologists responded to our DocStyles questions on HPV vaccination, CA-125, transvaginal ultrasound, and pelvic examination knowledge and beliefs. Analyses from the DocStyles survey indicated that almost 50% of primary care physicians responded that CA-125 alone or CA-125 and transvaginal ultrasound were effective ovarian cancer screens in the asymptomatic, average-risk population, 24 a belief that is inconsistent with screening guidelines for ovarian cancer. Obstetrician/gynecologists more often had guidelinesconsistent responses, with a little over half (56%) responding that neither CA-125 nor transvaginal ultrasound was an effective screen in the asymptomatic, average-risk population, compared to internists and general or family practitioners.…”

High-grade Ovarian Cancer Associated H/ACA snoRNAs Promote Cancer Cell Proliferation and Survival

“…Currently there are two tests being used for ovarian cancer screens, transvaginal ultrasound (TVUS) and measurement of blood levels of CA-125 protein (7)(8)(9). TVUS may only detect tumours of a certain mass and as such is not effective for very early stages of cancer development nor for differentiating between HGSC and SBT.…”