A common blood test for ovarian cancer is more likely to fall short for Black and Native American women
In 2022, more than 13,000 people died from ovarian cancer, according to the CDC.
A common blood test for ovarian cancer is more likely to fall short for Black and Native American women, according to a new study.
This was the case for Nefa-Tari Moore, 45, a three time "thriver" of gynecological cancer.
The blood test for CA-125, a commonly used marker for ovarian cancer, was never elevated for her, even when she was diagnosed with ovarian cancer at 38.
"All three times that I was diagnosed with cancer, the CA-125 wasn't a marker for me," Moore told ABC News.
CA-125 was discovered in 1980 and was quickly integrated into clinical care.
"It's one of the key parts of international as well as national algorithms for who should be referred to [gynecologic] oncology," Dr. Anna Jo Smith, lead author of the new study, published March 20 in JAMA Network Open, and a gynecologic oncologist at University of Pennsylvania, told ABC News.
However, the initial studies measuring levels of CA-125 in ovarian cancer were done in predominantly white populations, said Smith. Many noncancerous conditions can raise or lower CA-125 levels.
More research is needed into why some groups have higher or lower CA-125 levels, Smith said.
Current guidelines recommend referring people with an abdominal mass and elevated CA-125 levels to a cancer doctor.
However, Smith and her team analyzed records from more than 250,000 women with known ovarian cancer from 2004 to 2020 and found that Black and Native American women were 23% less likely to have elevated CA-125 levels.
This meant their cancers are more likely to be missed and potentially receive delayed treatment. In fact, study authors found that falsely negative or low levels of CA-125 were associated with an average nine-day delay in starting potentially lifesaving chemotherapy.
Smith worried that relying too heavily on CA-125 "could further exacerbate disparities in cancer care, leading to delays or potentially even nonreferrals" of Black or Native American people with normal CA-125 levels.
"We unfortunately know that both Black and Native American women are more likely to be diagnosed with late-stage ovarian cancer," said Smith. "They are also more likely to die of their disease."
Diagnosing ovarian cancer earlier improves chances of survival.
"The earlier patients get seen by us, the better they do," said Smith.
Ovarian cancer: Deadly and difficult to diagnose
More than 20,000 people were newly diagnosed with ovarian cancer in 2021, according to the U.S. Centers for Disease Control and Prevention.
In 2022, more than 13,000 people died from ovarian cancer.
Ovarian cancer may not be as prevalent as breast cancer, but it is more deadly. The likelihood of survival for someone diagnosed with breast cancer five years ago is 91%. For ovarian cancer, that survival rate decreases to 50%.
The poor survival rate of ovarian cancer can be due to delayed diagnosis, according to Dr. Melissa Simon, an OB-GYN at Northwestern Medicine, who is not associated with the study.
One of the challenges of diagnosing ovarian cancer are the vague symptoms, which include nausea, feeling bloated, early satiety, and abdominal distension, according to Simon.
Unfortunately, many people with these symptoms are not referred to a cancer doctor, said Smith. "It's not an uncommon story for a patient to come to me who's had signs or symptoms for years and has been dismissed," she said.
Moore had a similar experience. She said she remembers how her symptoms were initially dismissed at a local emergency room, and she told her doctor, "I know something is wrong with my body."
While battling ovarian cancer, Moore was connected with SHARE Cancer Support, a nonprofit organization that supports people diagnosed with with breast or gynecologic cancer, according to its website.
Now the director of Black women's outreach at SHARE Cancer Support, Moore shared some practical tips for people navigating gynecological cancer.
"Black women can advocate for themselves by educating themselves on the diagnosis that they've received," she said, adding that people can also join a support group to "be in contact with others diagnosed with cancer and see how they have survived and are thriving through their experience."
If you have a family history of ovarian cancer in a first or second degree relative, Smith recommends approaching your OB/GYN to discuss potential screening.
"Ask for imaging, even just an ultrasound, which is a very non-invasive test, can be helpful for looking at the ovaries if you have signs and symptoms," she said.
Both Smith and Simon agree more research in diverse populations is needed to determine better markers for ovarian cancer.
"We need research to represent our population," said Simon.
Sejal Parekh, M.D., is a board-certified practicing pediatrician and a member of the ABC News Medical Unit.
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