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Racial/ethnic differences in average CA125 and CA15.3 values and its correlates among postmenopausal women in the USA

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Abstract

Purpose

Among healthy postmenopausal women, levels of CA125 and CA15.3 are influenced by demographic and reproductive factors, including race/ethnicity. In this study, we sought to examine the interaction between race/ethnicity and other correlates of these biomarkers and whether the racial differences observed are simply determined by other correlates with racial differences.

Methods

In archived sera from 946 postmenopausal women who participated in the 2001–2002 cycle of the National Health and Nutrition Examination Survey, we measured CA125 and CA15.3 and examined their associations with health survey and examination data available in this cohort. We used multivariable linear regression to examine the association between CA125 and CA15.3 and race/ethnicity. We then calculated geometric means of these markers by demographic and reproductive factors stratified by race/ethnicity and used likelihood ratio tests to evaluate heterogeneity.

Results

Non-white race was associated with lower CA125, with Non-Hispanic Black women being associated with − 29.0% (95% CI − 42.5%, − 12.2%) difference and Mexican American women being associated with − 6.4% (95% CI − 18.1%, 6.9%) difference on average compared to Non-Hispanic White women. Associations between CA125 and age and parity varied by race/ethnicity. Non-Hispanic Black women were associated with higher CA15.3 compared to Non-Hispanic White women, with 17.3% (95% CI − 0.5%, 38.3%) differences on average. Associations between CA15.3 and age, number of births, and age at natural menopause varied by race/ethnicity.

Conclusions

Among postmenopausal women, Non-Hispanic Black women were associated with lower CA125 and higher CA15.3 levels compared to Non-Hispanic White women. Our results support that race/ethnicity should be considered when assigning thresholds for these biomarkers being tested for diagnostic or screening purposes.

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Data availability

The NHANES datasets are available online [https://www.cdc.gov/nchs/nhanes/index.htm].

Code availability

All statistical analyses were conducted using SAS; programs are available from the corresponding author upon request.

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Acknowledgments

The authors would like to thank the participants of the National Health and Nutrition Examination Survey for their valuable contribution.

Funding

This work was supported by U.S. National Cancer Institute at the National Institutes of Health under the following award numbers: R01 CA193965 (K.L.T.), R01 CA 158119, R35 CA197605 (D.W.C.), and Minnesota Ovarian Cancer Alliance 2019 National Early Detection Research Grant Award (N.S.). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA, USA

    Naoko Sasamoto, Allison F. Vitonis, Kathryn L. Terry & Daniel W. Cramer

  2. Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA

    Naoko Sasamoto, Raina N. Fichorova, Kathryn L. Terry & Daniel W. Cramer

  3. Laboratory of Genital Tract Biology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA, USA

    Raina N. Fichorova & Hidemi S. Yamamoto

  4. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Kathryn L. Terry & Daniel W. Cramer

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  1. Naoko Sasamoto
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Corresponding author

Correspondence to Naoko Sasamoto.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the scientific and ethics panel of NHANES. Because the research involved specimens anonymous to us, it was deemed exempt by the Brigham and Women’s Hospital Human Research Committee.

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Sasamoto, N., Vitonis, A.F., Fichorova, R.N. et al. Racial/ethnic differences in average CA125 and CA15.3 values and its correlates among postmenopausal women in the USA. Cancer Causes Control 32, 299–309 (2021). https://doi.org/10.1007/s10552-020-01384-z

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