{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:55:30Z","timestamp":1778658930991,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"7069","license":[{"start":{"date-parts":[[1996,11,30]],"date-time":"1996-11-30T00:00:00Z","timestamp":849312000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1996,9,24]]},"published-print":{"date-parts":[[1996,11,30]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:bold>\n : To determine the risk of invasive epithelial ovarian cancer and fallopian tube cancer associated with a raised concentration of the tumour marker CA 125 in asymptomatic postmenopausal women.\n <\/jats:p>\n \n Design<\/jats:bold>\n : Serum CA 125 concentration was measured annually in study participants for one to four years. Participants with a concentration >\/=30 U\/ml were recalled for abdominal ultrasonography. Follow up was by annual postal questionnaire.\n <\/jats:p>\n \n Setting<\/jats:bold>\n : General practice, occupational health departments, ovarian cancer screening unit in a teaching hospital.\n <\/jats:p>\n \n Subjects<\/jats:bold>\n : 22 000 volunteers, all postmenopausal women >\/=45 years of age; recruited between 1 June 1986 and 1 May 1990.\n <\/jats:p>\n \n Intervention<\/jats:bold>\n : Surgical investigation if the ultrasound examination was abnormal.\n <\/jats:p>\n \n Main outcome measures<\/jats:bold>\n : Cumulative and relative risk of developing an index cancer (invasive epithelial cancer of the ovary or fallopian tube) after a specified CA 125 result.\n <\/jats:p>\n \n Results<\/jats:bold>\n : 49 index cancers developed in the study population during a mean follow up of 6.76 years. The overall cumulative risk of developing an index cancer was 0.0022 for the entire study population and was lower for women with a serum CA 125 concentration <30 U\/ml (cumulative risk 0.0012) but was appreciably increased for women with a concentration >\/=30 U\/ml (0.030) and >100 U\/ml (0.149). Compared with the entire study population the relative risk of developing an index cancer within one year and five years was increased 35.9-fold (95% confidence interval 18.3 to 70.4) and 14.3-fold (8.5 to 24.3) respectively after a serum CA 125 concentration >\/=30 U\/ml and 204.8-fold (79.0 to 530.7) and 74.5-fold (31.1 to 178.3) respectively after a concentration >\/=100 U\/ml.\n <\/jats:p>\n \n Conclusion<\/jats:bold>\n : CA 125 is a powerful index of risk of ovarian and fallopian tube cancer in asymptomatic postmenopausal women.\n <\/jats:p>\n \n \n \n Key messages<\/jats:title>\n \n \n This study shows that raised serum CA 125 concentration is a powerful index of risk of ovarian cancer in asymptomatic postmenopausal women<\/jats:p>\n <\/jats:list-item>\n \n The risk in the year after a serum CA 125 concentration >\/=100 U\/ml is similar to the lifetime risk to women in high risk families<\/jats:p>\n <\/jats:list-item>\n \n The importance of a raised serum CA 125 concentration in relation to risk of other cancers is not yet known<\/jats:p>\n <\/jats:list-item>\n \n The role of CA 125 as a component of a screening strategy for ovarian cancer is under investigation, but the impact on mortality is not known<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n <\/jats:boxed-text>\n <\/jats:p>","DOI":"10.1136\/bmj.313.7069.1355","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:44:00Z","timestamp":1319744640000},"page":"1355-1358","source":"Crossref","is-referenced-by-count":152,"title":["Risk of diagnosis of ovarian cancer after raised serum CA 125 concentration: a prospective cohort study"],"prefix":"10.1136","volume":"313","author":[{"given":"Ian J","family":"Jacobs","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Skates","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Prys","family":"Davies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P","family":"Woolas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjun","family":"Jeyerajah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pru","family":"Weidemann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Sibley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H","family":"Oram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,11,30]]},"reference":[{"key":"2025122312142076000_313.7069.1355.1","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1172\/JCI110380","article-title":"Reactivity of a monoclonal antibody with human ovarian carcinoma","volume":"68","author":"Bast","year":"1981","journal-title":"J Clin Invest"},{"key":"2025122312142076000_313.7069.1355.2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJM198310133091503","article-title":"A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer","volume":"309","author":"Bast","year":"1983","journal-title":"N Engl J Med"},{"key":"2025122312142076000_313.7069.1355.3","first-page":"99","article-title":"Clinical perspectives in using CA 125","volume":"41","author":"Knapp","year":"1996","journal-title":"Contemporary Obstetrics and Gynecology"},{"key":"2025122312142076000_313.7069.1355.4","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/S0140-6736(88)90351-0","article-title":"Multimodal approach to screening for ovarian cancer","volume":"i","author":"Jacobs","year":"1988","journal-title":"Lancet"},{"key":"2025122312142076000_313.7069.1355.5","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1136\/bmj.306.6884.1030","article-title":"Prevalence screening for ovarian cancer in postmenopausal women by CA 125 measurement and ultrasonography","volume":"306","author":"Jacobs","year":"1993","journal-title":"BMJ"},{"key":"2025122312142076000_313.7069.1355.6","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/ijc.2910420507","article-title":"Elevated serum CA 125 levels prior to diagnosis of ovarian neoplasia; relevance for early detection of ovarian cancer","volume":"42","author":"Zurawski","year":"1988","journal-title":"Int J Cancer"},{"key":"2025122312142076000_313.7069.1355.7","first-page":"14","article-title":"Prospective evaluation of serum CA 125 levels for early detection of ovarian cancer","volume":"80","author":"Einhorn","year":"1992","journal-title":"Obstet Gynecol"},{"key":"2025122312142076000_313.7069.1355.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500090059033"},{"key":"2025122312142076000_313.7069.1355.9","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1994.1065"},{"key":"2025122312142076000_313.7069.1355.10","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1046\/j.1525-1438.1994.04060384.x","article-title":"What is the true incidence of fallopian tube carcinoma","volume":"4","author":"Woolas","year":"1996","journal-title":"Int J Gynecol Cancer"},{"key":"2025122312142076000_313.7069.1355.11","unstructured":"Office of Population Censuses and Surveys. Cancer statistics, registrations. Cases of diagnosed cancer registered in England and Wales. London: HMSO, 1989."},{"key":"2025122312142076000_313.7069.1355.12","unstructured":"Rothman KJ. Modern epidemiology. Boston: Little, Brown, 1986:218."},{"key":"2025122312142076000_313.7069.1355.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91578-4"},{"key":"2025122312142076000_313.7069.1355.14","first-page":"386","article-title":"Strategies for improving the specificity of screening for ovarian cancer with tumour associated antigens CA 125, CA 15\u20133 and TAG 72.3","volume":"80","author":"Jacobs","year":"1992","journal-title":"Obstet Gynecol"},{"key":"2025122312142076000_313.7069.1355.15","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19951115)76:10+<2004::AID-CNCR2820761317>3.0.CO;2-G"},{"key":"2025122312142076000_313.7069.1355.16","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.21.1748"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.313.7069.1355","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.313.7069.1355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T20:14:28Z","timestamp":1766520868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.313.7069.1355"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,11,30]]},"references-count":16,"journal-issue":{"issue":"7069","published-online":{"date-parts":[[1996,11,30]]},"published-print":{"date-parts":[[1996,11,30]]}},"alternative-id":["10.1136\/bmj.313.7069.1355"],"URL":"https:\/\/doi.org\/10.1136\/bmj.313.7069.1355","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,11,30]]}}}