(HealthDay News) – Among asymptomatic women, high-risk categories for predicting ovarian cancer risk can be identified using CA125, transvaginal ultrasonography, or both, providing guidance for clinical decisions regarding need for surgery in these women, according to research published in the January issue of Obstetrics & Gynecology.
Edward E. Partridge, MD, of the University of Alabama at Birmingham, and colleagues estimated the risk of ovarian malignancy using data from a cohort of 3,224 asymptomatic postmenopausal women from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The participants had an abnormal transvaginal ultrasound scan or CA125 level at an initial (T0) or subsequent annual (T1) screening.
At T0, the researchers identified two high-risk categories: negative transvaginal ultrasound scan and CA125 of >70 (positive predictive value [PPV], 15.9%); and positive for CA125 and transvaginal ultrasound (PPV, 25%). The high-risk T0 criteria had a sensitivity of 60%, a specificity of 96.2%, a PPV of 19.7%, and a negative predictive value (NPV) of 99.3%. Three high-risk categories were identified at the T1 screening: change in CA125 of >45 with negative ultrasound (PPV, 29%); negative CA125 and increase of >6cm in size of cyst (PPV, 13.3%); and positive for both tests (PPV, 42.9%). High-risk T1 criteria had a sensitivity of 85.3%, a specificity of 95.6%, a PPV of 29.6%, and an NPV of 99.7%.
“The large number of women in this study, the four-year complete follow-up, and small number of invasive cancers in the low-risk categories provide guidance for clinical decisions regarding need for surgery in these women,” the authors write.