Send to

Choose Destination
See comment in PubMed Commons below
Gynecol Oncol. 2015 Nov;139(2):253-60. doi: 10.1016/j.ygyno.2015.08.024. Epub 2015 Sep 3.

Identifying post-menopausal women at elevated risk for epithelial ovarian cancer.

Author information

  • 1Fred Hutchinson Cancer Research Center, Seattle, WA, United States. Electronic address:
  • 2Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
  • 3Cedars-Sinai Medical Center, Los Angeles, CA, United States.
  • 4Johns Hopkins Medicine, Baltimore, MD, United States.
  • 5Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
  • 6Cancer Prevention, Inc., Las Vegas NV and Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • 7Fox Chase Cancer Center, Philadelphia PA, United States.
  • 8University at Buffalo, SUNY, Buffalo, NY, United States.
  • 9University of Miami, Miami, FL, United States.
  • 10University of Texas Health Science Center, San Antonio TX, United States.
  • 11Stony Brook University, Stony Brook, NY, United States.



We developed and validated a hybrid risk classifier combining serum markers and epidemiologic risk factors to identify post-menopausal women at elevated risk for invasive fallopian tube, primary peritoneal, and ovarian epithelial carcinoma.


To select epidemiologic risk factors for use in the classifier, Cox proportional hazards analyses were conducted using 74,786 Women's Health Initiative (WHI) Observational Study (OS) participants. To construct a combination classifier, 210 WHI OS cases and 536 matched controls with serum marker measurements were analyzed; validation employed 143 cases and 725 matched controls from the WHI Clinical Trial (CT) with similar data.


Analyses identified a combination risk classifier composed of two elevated-risk groups: 1) women with CA125 or HE4 exceeding a 98% specificity threshold; and 2) women with intact fallopian tubes, prior use of menopausal hormone therapy for at least two years, and either a first degree relative with breast or ovarian cancer or a personal history of breast cancer. In the WHI OS population, it classified 13% of women as elevated risk, identifying 30% of ovarian cancers diagnosed up to 7.8years post-enrollment (Hazard Ratio [HR]=2.6, p<0.001). In the WHI CT validation population, it classified 8% of women as elevated risk, identifying 31% of cancers diagnosed within 7years of enrollment (HR=4.6, p<0.001).


CA125 and HE4 contributed significantly to a risk prediction classifier combining serum markers with epidemiologic risk factors. The hybrid risk classifier may be useful to identify post-menopausal women who would benefit from timely surgical intervention to prevent epithelial ovarian cancer.


CA125; HE4; Ovarian cancer; Risk prediction

[PubMed - indexed for MEDLINE]
Free PMC Article

Publication Types, MeSH Terms, Substances, Supplementary Concepts, Grant Support

Publication Types

MeSH Terms


Supplementary Concepts

Grant Support

PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center