CA-125 is a protein that is found in greater concentration in tumor cells, particularly ovarian cancer cells, than in other cells of the body.

Every year approximately 1600 women are diagnosed with ovarian cancer in Australia. The 5 year survival rate is just 44% – that’s because there are often no obvious symptoms and so the cancer is only diagnosed once it has spread.

The study, published by the Oxford University Press, supports evidence that elevated CA-125 levels (more than 35 U/mL) have high specificity for detecting ovarian cancer in women who present to a GP with abdominal bloating, pelvic pain or urinary symptoms.

Researchers reviewed more than 2900 CA-125 tests ordered by GPs over one year and found that 8% were elevated and, of these, 11% of women had ovarian or peritoneal cancer. A further 11% had other serious pathology.

They suggest that these findings show that CA-125 is a useful diagnostic test, if it is followed up early and any changes are monitored over time.

The researchers did not, however, recommend that the CA-125 biomarker be used as a screening test for low-risk women with no symptoms due to the test’s poor sensitivity and the potential for over-investigation and subsequent distress for patients who do not have ovarian cancer.

Melbourne GP Professor Jon Emery, professor of primary care cancer research at the University of Melbourne, spoke to Australian Doctor and said the findings added to the existing evidence that CA-125 might be a useful biomarker but that Australian GPs had been slow to implement recommendations on its use.

The National Cancer Expert Reference Group released ovarian cancer Optimal Care Pathways in June 2016 to improve care for ovarian cancer patients in Australia. The group recommends CA-125 testing for women presenting to their GP with potential symptoms, alongside routine blood tests, pelvic ultrasound and CT scan if appropriate, but local awareness is poor.

“Many GPs are not yet aware of the Optimal Care Pathway, but there are various initiatives across the states beginning to raise awareness of them and implement them in general practice,” Professor Emery said.

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One of the questions on researchers’ minds since the outbreak was declared over has been why those 11,000 died out of the 28,000 reported cases of infection.

There are some obvious factors; supportive hospital care improves prognosis, whilst a high amount of virus in the body increases likelihood of death. But these factors alone didn’t always predict who would live or die. So what else could be at play? And could research into the issue provide us with valuable information to stop a similar epidemic spreading again?

A team of researchers led by Boston University has discovered a biomarker that they say can help predict the progression of the disease. A handful of genes that are over-activated and therefore produce an overly aggressive immune response to the virus have been found in those that succumb to the disease. This response can damage organs—particularly the liver—and therefore hamper a more targeted immune response.

The research team discovered the biomarker whilst analyzing blood samples from the 2014 Ebola epidemic. A/Prof John Connor, an author on the study, said;

“The study suggests that something about the way people respond to infection affects their chance of survival. We can get a sense of who will survive and who won’t, and we can get it earlier.”

The blood test is in the preliminary development stages and the study is limited (samples were used from the 2014 outbreak which involved only one strain of the virus) but A/Prof Connor believes it is likely similar biomarkers will appear with other strains. And the team are optimistic that it might be useful in future outbreaks to steer patients to the best treatment. Connor added;

“The nature of the victim’s immune response has something to do with it, but the information we got from these samples is a one-time snapshot. This study gives us an important piece of information, but it doesn’t solve the whole puzzle.”

Read more on the Boston University website or see the full study published in the journal Genome Biology, suggests a new type of blood test that while still in the preliminary stages of development, might be useful in

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