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CA-125 Tests & CT Scans in Ovarian Cancer

JAMA Oncol; ePub 2016 Jul 21; Esselen, Cronin, et al

The use of cancer antigen 125 (CA-125) tests and computed tomographic (CT) scans for surveillance testing in patients with ovarian cancer are routine; however, their benefit has not been proven and their use may have significant implications for the quality of life as well as costs. This according to a cohort of 1,241 women (mean age 59) with ovarian cancer in clinical remission after completion of primary cytoreductive surgery and chemotherapy at 6 National Cancer Institute designated cancer centers between January 1, 2004 and December 31, 2011 and followed-up through December 31, 2012, to study to use of CA-125 tests and CT scans before and after 2009. Researchers found:

• During 12 months surveillance, the cumulative incidence of patients undergoing 3 or more CA-125 tests was 86% from 2004 to 2009 vs 91% from 2010 to 2012.

• Cumulative incidence of patients undergoing >1 CT scan was 81% from 2004 to 2009 vs 78% from 2010 to 2012.

• There was no significant difference in the time to retreatment with chemotherapy before and after 2009 among women whose CA-125 markers doubled (n=511).

• US population surveillance cost estimate was $1,999,029 per year for CA-125 tests alone and $16,194,647 per years with CT scans added.

Citation: Esselen KM, Cronin AM, Bixel K, et al. Use of CA-125 tests and computed tomographic scans for surveillance in ovarian cancer. [Published online ahead of print July 21, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.1842.