Background
Methods
Study population
PLCO
EPIC
NHS/NHSII
NEC
CA125 predictor variables
CA125 measurements
Statistical analysis
Recalibration of CA125
Prediction modeling
Linear model
Dichotomous model
Results
Recalibration of CA125
Linear model
Age-adjusted model | ||||
---|---|---|---|---|
Characteristics | N (%) | Mean CA125 (U/mL) a | % change | p-value |
Age | ||||
< 60 years | 9388 (35) | 10.1 (10.0, 10.2) | Ref | Ref |
60–64 years | 8351 (31) | 10.4 (10.3, 10.5) | 3.6 | <.0001 |
65–69 years | 5814 (22) | 10.7 (10.5, 10.8) | 5.8 | <.0001 |
≥70 years | 3428 (13) | 10.8 (10.6, 11.0) | 7.1 | <.0001 |
p-trend | <.0001 | |||
Race | ||||
White | 24,166 (90) | 10.6 (10.5, 10.7) | Ref | Ref |
Black | 1340 (5) | 8.0 (7.8, 8.3) | −24 | <.0001 |
Hispanic | 368 (1) | 9.2 (8.8, 9.7) | −12.6 | <.0001 |
Asian | 922 (3) | 10.0 (9.7, 10.3) | −6.4 | <.0001 |
Pacific Islander, Native American | 185 (1) | 9.2 (8.6, 9.9) | −13.2 | <.0001 |
Body mass index | ||||
≤ 18.5 kg/m2 | 283 (1) | 11.4 (10.8, 12.1) | 7 | 0.02 |
18.5 < −25 kg/m2 | 10,778 (40) | 10.6 (10.5, 10.7) | Ref | Ref |
25 < −30 kg/m2 | 9408 (35) | 10.4 (10.3, 10.5) | − 1.4 | 0.04 |
> 30 kg/m2 | 6512 (24) | 10.0 (9.9, 10.1) | −5.4 | <.0001 |
p-trend | <.0001 | |||
Smoking | ||||
Never | 15,288 (57) | 10.4 (10.4, 10.5) | Ref | Ref |
Current | 2471 (9) | 9.3 (9.1, 9.4) | −10.8 | <.0001 |
Former | 9222 (34) | 10.7 (10.6, 10.8) | 2.3 | 0.0004 |
Pack-years among current smokers | ||||
< 13 | 49 (2) | 8.5 (7.4, 9.7) | Ref | Ref |
13–30 | 717 (29) | 9.1 (8.8, 9.5) | 7.4 | 0.33 |
≥ 30 | 1705 (69) | 9.3 (9.1, 9.5) | 10.1 | 0.18 |
p-trend | 0.003 | |||
Pack-years among former smokers | ||||
< 13 | 3370 (37) | 10.5 (10.3, 10.7) | Ref | Ref |
13–30 | 2765 (30) | 10.5 (10.3, 10.7) | −0.1 | 0.91 |
≥ 30 | 3087 (33) | 10.9 (10.7, 11.1) | 3.4 | 0.01 |
p-trend | 0.003 | |||
Age at first menstrual period | ||||
< 10 years | 388 (1) | 9.8 (9.3, 10.3) | −5.3 | 0.03 |
10–11 years | 4870 (18) | 10.3 (10.1, 10.4) | −1.6 | 0.05 |
12–13 years | 14,703 (54) | 10.4 (10.4, 10.5) | Ref | Ref |
14–15 years | 5845 (22) | 10.5 (10.4, 10.6) | 0.1 | 0.85 |
≥ 16 years | 1153 (4) | 10.2 (10.0, 10.5) | −2.2 | 0.15 |
p-trend | 0.18 | |||
Oral contraceptive use | ||||
Never | 12,249 (45) | 10.4 (10.3, 10.5) | Ref | Ref |
Ever | 14,720 (55) | 10.4 (10.3, 10.5) | 1.0 | 0.11 |
Duration of oral contraceptive use among ever users | ||||
< 1 year | 3892 (26) | 10.3 (10.2, 10.5) | Ref | Ref |
2–3 years | 3046 (21) | 10.2 (10.1, 10.4) | −0.3 | 0.79 |
4–5 years | 1989 (14) | 10.2 (10.0, 10.4) | −0.7 | 0.62 |
6–9 years | 2450 (17) | 10.3 (10.1, 10.5) | 0.7 | 0.58 |
≥ 10 years | 3315 (23) | 10.6 (10.4, 10.8) | 2.9 | 0.01 |
p-trend | 0.01 | |||
Parity | ||||
0 | 2396 (9) | 10.1 (9.9, 10.3) | Ref | Ref |
1 | 1938 (7) | 10.0 (9.8, 10.2) | −0.9 | 0.54 |
2 | 6238 (23) | 10.5 (10.3, 10.6) | 4.1 | 0.001 |
3 | 6692 (25) | 10.4 (10.3, 10.6) | 3.6 | 0.003 |
4 | 4598 (17) | 10.6 (10.4, 10.7) | 4.2 | 0.001 |
≥ 5 | 5119 (19) | 10.4 (10.3, 10.6) | 2.6 | 0.03 |
p-trend | 0.02 | |||
Benign ovarian cyst | ||||
No | 23,561 (90) | 10.4 (10.4, 10.5) | Ref | Ref |
Yes | 2689 (10) | 10.2 (10.0, 10.4) | −2.0 | 0.05 |
Endometriosis | ||||
No | 24,587 (94) | 10.4 (10.4, 10.5) | Ref | Ref |
Yes | 1610 (6) | 10.2 (10.0, 10.4) | −1.3 | 0.17 |
Hysterectomy | ||||
No | 19,597 (73) | 10.8 (10.7, 10.8) | Ref | Ref |
Yes | 7384 (27) | 9.5 (9.4, 9.6) | −11.9 | <.0001 |
Age at last menstrual period | ||||
< 40 years | 3655 (14) | 9.4 (9.2, 9.5) | −11.8 | <.0001 |
40–44 years | 3499 (13) | 10.0 (9.8, 10.2) | −6.6 | <.0001 |
45–49 years | 6092 (23) | 10.4 (10.3, 10.5) | −2.9 | 0.0002 |
50–54 years | 10,448 (39) | 10.7 (10.6, 10.8) | Ref | Ref |
≥ 55 years | 3287 (12) | 11.2 (11.0, 11.4) | 5.3 | <.0001 |
p-trend | <.0001 | |||
Time since menopause | ||||
< 5 years | 3254 (12) | 10.6 (10.5, 10.8) | Ref | Ref |
5–9 years | 5120 (19) | 10.5 (10.4, 10.7) | −4.9 | <.0001 |
10–14 years | 5826 (22) | 10.5 (10.4, 10.6) | −8.7 | <.0001 |
15–19 years | 6356 (24) | 10.2 (10.1, 10.4) | −12.9 | <.0001 |
≥ 20 years | 6425 (24) | 10.2 (10.1, 10.4) | −17.4 | <.0001 |
p-trend | <.0001 | |||
Hormone therapy use | ||||
Never | 9493 (35) | 10.2 (10.1, 10.3) | Ref | Ref |
Ever | 17,488 (65) | 10.5 (10.4, 10.6) | 3.9 | <.0001 |
Duration of hormone therapy b | ||||
≤ 1 year | 3267 (19) | 10.3 (10.1, 10.5) | Ref | Ref |
2–3 years | 2860 (16) | 10.5 (10.3, 10.7) | 2.9 | 0.03 |
4–5 years | 2508 (14) | 10.4 (10.2, 10.6) | 2.3 | 0.08 |
6–9 years | 3421 (20) | 10.6 (10.5, 10.8) | 4.3 | 0.001 |
≥ 10 years | 5432 (31) | 10.6 (10.4, 10.7) | 1.8 | 0.11 |
p-trend | 0.15 | |||
Family history of ovarian cancer | ||||
No | 25,471 (96) | 10.4 (10.3, 10.5) | Ref | Ref |
Yes | 1049 (4) | 10.3 (10.0, 10.6) | −0.8 | 0.59 |
Family history of breast cancer | ||||
No | 22,682 (86) | 10.4 (10.4, 10.5) | Ref | Ref |
Yes | 3837 (14) | 10.3 (10.1, 10.5) | −1.3 | 0.12 |
Previous history of cancer | ||||
No | 25,250 (94) | 10.4 (10.3, 10.4) | Ref | Ref |
Yes | 1731 (6) | 10.7 (10.4, 10.9) | 2.3 | 0.06 |
Predictor | % Change in CA125 levels c | p-value |
---|---|---|
Age a (per year) | 0.5 | < 0.0001 |
Race | ||
White | Ref | Ref |
Black | −20.7 | < 0.0001 |
Hispanic | −12.0 | < 0.0001 |
Asian | −8.5 | < 0.0001 |
Other | −11.4 | 0.005 |
Body Mass Index b (per kg/m2) | −0.4 | < 0.0001 |
Smoking status | ||
Never | Ref | Ref |
Current | −16.9 | < 0.0001 |
Former | 0.5 | 0.60 |
Pack-years among current smokers | 0.2 | 0.001 |
Pack-years among former smokers | 0.1 | 0.02 |
Parity (per child) | 0.9 | 0.0001 |
Hysterectomy | −11.2 | < 0.0001 |
Age at last menstrual period | ||
< 40 years | −2.5 | 0.08 |
40–44 years | −1.7 | 0.18 |
45–49 years | −0.6 | 0.53 |
50–54 years | Ref | Ref |
≥ 55 years | 4.6 | 0.0001 |
Hormone therapy | ||
Never | Ref | Ref |
Ever | 2.1 | 0.85 |
Duration of hormone therapy | ||
0 years | Ref | Ref |
≤ 1 year | −0.04 | 0.99 |
2–3 years | 1.7 | 0.88 |
4–5 years | 1.7 | 0.88 |
6–9 years | 2.4 | 0.83 |
≥ 10 years | 4.2 | 0.71 |
R-square | 0.05 |
Dichotomous model
Predictor | Odds Ratio (95% CI)a |
---|---|
Age (per year) | 1.04 (1.01–1.07) |
Race | |
White | Ref |
Non-white | 0.68 (0.47–0.99) |
Body mass index (kg/m2) | 0.95 (0.93–0.97) |
Smoking | |
Never | Ref |
Current | 0.72 (0.31–1.64) |
Former | 1.01 (0.78–1.31) |
Pack-years among current smokers | 1.00 (0.98–1.02) |
Pack-years among former smokers | 1.01 (1.00–1.01) |
Hysterectomy | |
No | Ref |
Yes | 0.54 (0.41–0.73) |
Time since menopause | |
< 5 years | Ref |
5–9 years | 0.76 (0.52–1.04) |
10–14 years | 0.70 (0.46–1.05) |
15–19 years | 0.83 (0.52–1.31) |
≥ 20 years | 0.96 (0.56–1.64) |
Duration of HT use | |
Never users | Ref |
≤ 1 year | 0.60 (0.41–0.87) |
2–3 years | 0.80 (0.55–1.15) |
4–5 years | 0.88 (0.60–1.29) |
6–9 years | 1.27 (0.94–1.71) |
≥ 10 years | 1.22 (0.94–1.58) |
AUC | 0.64 (0.61–0.66) |