Demographic profile, staging and CA-125 levels in a patient with pelvic lesions of probable ovarian origin at presentation in a tertiary care hospital

Abstract

Background: In Indian women, ovarian cancer is one of the most commonly diagnosed cancer. We wanted to analyze the demographic profile, staging, and sensitivity and specificity of CA-125 levels in a patient with ovarian cancer in an indian scenario.Methods: A retrospective study was performed and information was collected from 250 patients who visited SGRD Hospital, Vallah, Amritsar from 1 April 2016 to 30 April 2020, with pelvic lesions of probable ovarian origin on demographic profile, the staging of the disease and CA-125 levels. Data was collected, analyzed, and presented in frequency tables and figures.Results: The study comprised of 250 patients. CA-125 was mainly used to investigate a wide range of signs and symptoms and few tests were for follow up or screening of ovarian cancer. In female patients having a CA-125 for very high suspicion of malignancy/ovarian cancer, only 90 (36%) of the abnormal results were caused by ovarian cancer. False-positive results were largely caused by other malignancies. The specificity of CA-125 for ovarian cancer increased with concentrations over 1000 kU/litre. Serous adenocarcinoma was found the most common malignant tumor type of the ovary (53%). In the demographic profile, ovarian cancer was found to be highest in the sikh religious group (75%) and prevalent in the middle socioeconomic status 32% (n=80).Conclusions: These results confirm the high false-positive rate and poor sensitivity and specificity associated with CA-125 and the most common tumor type. The substantial inappropriate usage of CA-125 has led to results that are useless to the clinician, have cost implications, and add to patient anxiety and clinical uncertainty.