A recent study highlights how a commonly used blood test may overlook ovarian cancer in some Black and Native American patients, potentially delaying vital treatment. This insight adds to a growing body of evidence on how medical tests can perpetuate disparities in healthcare outcomes. Researchers continue to investigate these biases, even as federal efforts aimed at diversity and inclusion face challenges.
Ovarian cancer rates peak among Native American women, while Black women face lower survival rates compared to their white counterparts. Early detection is crucial for improving survival odds. The study, funded by the National Cancer Institute and published in JAMA Network Open, focuses on the CA-125 test. This test detects a tumor marker in the blood, aiding doctors in deciding whether to refer a patient to a cancer specialist.
The CA-125 test is a critical tool in early cancer evaluations. According to Dr. Shannon Westin from MD Anderson Cancer Center, although she was not part of the research, understanding the test’s implications across various races and ethnicities is essential. She pointed out, “This work needed to be stratified based on race and ethnicity.” The findings serve as a warning that doctors should not be overly reassured by a normal test result in minority groups.
The exact reason the CA-125 test yields different results across ethnic groups is not yet known, although researchers suspect it’s linked to benign genetic variations prevalent in people of African, Caribbean, Middle Eastern, and West Indian backgrounds. Initial studies from the 1980s focused on predominantly white populations and did not account for racial differences.
Lead author Dr. Anna Jo Smith from the University of Pennsylvania acknowledges that the CA-125 test isn’t infallible for white women either. However, she notes that “worse performance in certain groups may further contribute to disparities in treatment and lower survival rates among Black women with ovarian cancer.”
Analyzing data from over 200,000 women with ovarian cancer from 2004 to 2020, researchers discovered that Black and Native American patients were 23% less likely to present with elevated CA-125 levels at diagnosis compared to white patients. This suggests current test thresholds may be too high. Among those with false negatives, there was an average delay of nine days in starting chemotherapy, which could alter patient outcomes.
Dr. Smith and her colleagues have proposed a new threshold for the test in a presentation to the Society of Gynecologic Oncology. This adjustment aims to provide equitable effectiveness in ovarian cancer referrals across all populations, potentially influencing future guidelines.
“The establishment of new referral thresholds will ensure rapid and equitable care for all patients when ovarian cancer is a concern,” Smith stated.
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