Authors:
Jacobs IJ. Skates S. Davies AP. Woolas RP. Jeyerajah A. Weidemann P. Sibley K. Oram DH.
Institution:
Ovarian Cancer Screening Unit, Department Gynaecological Oncology, St Barts Hospital-Royal London Hosp,London EC1A 7BE; United Kingdom.
Title:
Risk of diagnosis of ovarian cancer after raised serum CA 125 concentration: A prospective cohort study (1996-1594).
Source:
BMJ. Vol 313(7069) (pp355-1358), 1996.
Abstract:
Objectives:
To determine the risk of invasive epithelial ovarian cancer and fallopian tube cancer associated with a raised concentration of the tumour marker CA 125 in asymptomatic postmenopausal women.
Design:
Serum CA 125 concentration was measured annually in study participants for one to four years. Participants with a concentration<= 30 U/ml were recalled for abdominal ultrasonography. Follow up was by annual postal questionnaire.
Setting:
General practice, occupational health departments, ovarian cancer screening unit in a teaching hospital. Subjects - 22,000 volunteers, all postmenopausal women<= 45 years of age; recruited between 1 June 1986 and 1 May 1990. Intervention - Surgical investigation if the ultrasound examination was abnormal.
Main Outcome Measures:
Cumulative and relative risk of developing an index cancer (invasive epithelial ovarian cancer or fallopian tube) after a specified CA 125 result.
Results:
49 index cancers developed in the study population during a mean follow up of 6.76 years. The overall cumulative risk of developing an index cancer was 0.0022 for the entire study population and was lower for women with a serum CA 125 concentration< 30 U/ml (cumulative risk 0.0012) but was appreciably increased for women with a concentration<= 30 U/ml (0.030) and > 100 U/ml (0.149). Compared with the entire study population the relative risk of developing an index cancer within one year and five years was increased 35.9-fold (95% confidence interval 18.3 to 70.4) and 14.3-fold (8.5 to 24.3) respectively after a serum CA 125 concentration<= 30 U/ml and 204.8-fold (79.0 to 530.7) and 74.5-fold (31.1 to 178.3) respectively after a concentration<= 100 U/ml.
Conclusion:
- CA 125 is a powerful index of risk of ovarian and fallopian tube cancer in asymptomatic postmenopausal women.
Please click on the required question.
- 1 What is cancer (malignancy)
- 2 What is meant by cancer staging?
- 3 How prevalent is cancer?
- 4 How prevalent are womens' cancers?
- 5 What causes cancer?
- 6 Is cancer a hereditary condition?
- 7 How can gynaecological cancer present?
- 8 How can we reduce the risks of the womens' cancers?
Reducing the Risks of Womens' Cancers.
- 9 What are screening tests?
- 10 What are the reactions to a diagnosis of cancer?
- 11 Is there a place for counselling when cancer is diagnosed?
- 12 Can personality alter the prognosis?
- 13 Is the incidence of deaths from the female cancers changing?
- 14 Is there a place for a holistic approach to cancer?
Cancer of the Cervix.
- 15 How prevalent is cervical cancer?
- 16 What causes cervical cancer?
- 17 How long an interval should there be between cervical screening (smear) (PAP) tests?
- 18 Is there any evidence that cervical screening can reduce the incidence of cervical cancer?
- 19 Will pre-malignant changes of the cervix invariably lead to cancer?
Endometrial Cancer (Uterus)
- 20 What causes endometrial cancer?
- 21 Are there screening tests for endometrial cancer?
- 22 How does endometrial cancer present?
- 22a How can endometrial cancer be prevented?
- 22b How can endometrial cancer be treated?
Cancer of the Ovary.
- 23 How does ovarian cancer present?
- 24 How prevalent is ovarian cancer?
- 25 What are tumour markers?
- 26 Can we screen for ovarian cancer?
- 27 What is the relationship between infertility and ovarian cancer?
- 28 Can treatment of infertility increase the risk of ovarian cancer?
- 29 What is the relationship between oral contraception and cancer?
- 30 Can ovarian cancer be prevented?
- 31 I use talcum power. Could this increase my risk of developing ovarian cancer?
The Treatment Of Womens' Cancers
- 32 Can we predict the course of a cancer?
- 33 What treatment options are available for gynaecological cancer?
- Q32.33c What treatment options are available for ovarian cancer?
Cancer of the Vulva, Vagina and Fallopian Tube
- 34 How prevalent are malignant conditions of the vulva, vagina and Fallopian tubes?
Breast Cancer
- 35 What is the incidence of breast cancer?
- 35 ?What is the cause of breast cancer?
- 35a What are the advantages of breast cancer screening - mammography - mammograms?
- 14 Is there a place for a holistic approach to cancer?
- 36 How often should breast screening be carried out?
- 37 Are there any problems having a mammogram?
- 38 Should I check myself for breast lumps?
- 39 One of my family developed cancer of the breast. Am I at increased risk?
- 40 We have a family tendency towards developing breast / ovarian cancer. Are there any genetic tests to find out if I am at increased risk?
- 41 What happens if a mammogram shows an abnormality?
- 42 What are the advantages and disadvantages of tamoxifen in the management of breast cancer?
- 42a Breast Cancer Treatment - What is available?
- 43 What is the relationship between breast cancer and the pill?
Web sites and Support Groups
- 44 Are there any support groups?
- 44 Are there any support groups?
- 45 Support Groups.
- 46 Breast Cancer Support Groups
- 47 Ovarian Cancer Support Groups
- 48 Endometrial Cancer Support Groups
- 49 Cervical Cancer Support Groups
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.














