A common blood test can miss ovarian cancer in some black and Indian patients, which their treatment is postponed, is a new study. It is the newest example of Medical tests that contribute to Differences in health care.
Researchers have worked to discover these kinds of prejudices in medicine. Recently the action of the Trump administration against diversity, equity and inclusion Such an investigation in danger As universities react to political pressure and federal agencies combing subsidies in search of projects that violate the president’s orders.
Indian women have the highest percentage of ovarian cancer. Black women with ovarian cancer have a lower chances of survival compared to white women. Finding ovarian cancer early can lead to better chances of survival.
The new studySupported by subsidies from the National Cancer Institute and published on Thursday in Jama Network Open, looked at a test called CA-125. The test measures a tumor marker in the blood and doctors use it to determine whether a woman with a suspicious clog should be referred to a cancer specialist.
Doctors depend on the test during early evaluations, so understanding what the results mean for people of different breeds and ethnic groups is crucial, Dr. Shannon Westin of MD Anderson Cancer Center in Houston, who was not involved in the investigation.
“This is a perfect example of work that absolutely had to be stratified on the basis of race and ethnicity,” said Westin. Doctors warn the findings that they should not be completely comfortable with a normal test result, she said.
So far it is unknown why the test does not perform uniform in groups. The researchers suspect that it has something to do with a harmless genetic variation that occurs more often in people of African, Caribbean, Midden -Eastern and West -Indian descent.
The first studies of the test, published in the 1980s, did not record human races, but were mainly in white populations.
The test is also not perfect for white women, said main author Dr. Anna Jo Smith from the Medical School of the University of Pennsylvania.
“But if we have poorer performance in certain groups, we can further contribute to differences in referral, differences in treatment and ultimately we can contribute to the lower survival in black women with ovarian cancer,” said Smith.
The researchers analyzed data from more than 200,000 women with ovarian cancer from 2004 to 2020 who had had a CA-125 blood test.
Black and Indian patients had 23% less chance of an increased CA-125 level in the diagnosis of ovarian cancer compared to white patients, suggesting that the current thresholds are too high.
The researchers also discovered that patients with false negative results started on average nine days later chemotherapy than patients with increased levels. That can make a difference for some patients, Smith said.
Last week, Smith and her colleagues presented work at a society of gynecological oncology meeting with proposing a new lower threshold for the blood test that would work better in all populations. The work can lead to changes in guidelines.
“New thresholds for referral will ensure that all patients quickly use rapid care when ovarian cancer is suspected,” Smith said.
– Carla K. Johnson