Evidence map›Paper›PMID 40962845›Full record

ArticleBritish journal of cancer2025

Cost-effectiveness of CA125- and age-informed risk-based triage for ovarian cancer detection in primary care.

Runguo Wu, Kirsten D Arendse, Tooba Hamdani, Fiona M Walter, Emma J Crosbie, Borislava Mihaylova, Garth Funston

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Is now the time to rethink risk thresholds in cancer referral guidelines?The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Runguo WuHealth Economics and Policy Research Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK. r.wu@qmul.ac.uk.ORCID http://orcid.org/0000-0002-6523-5754
Kirsten D ArendseCentre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0001-9046-1086
Tooba HamdaniHealth Economics and Policy Research Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Fiona M WalterCentre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Emma J CrosbieGynaecological Oncology Research Group, Division of Cancer Sciences, University of Manchester, Manchester, UK.ORCID http://orcid.org/0000-0003-0284-8630
Borislava Mihaylova *Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
Garth Funston *Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0002-4156-6401

Funding

Cancer Research UK (CRUK) C8640/A23385Department of Health NIHR203308Department of Health NIHR300650
6 · The paper itself

Abstract

backgroundIn England, current practice is cancer antigen 125 (CA125) testing with pelvic ultrasound scan (USS) if CA125 is ≥35 U/mL for triage of women with suspected ovarian cancer (OC) in primary care. However, OC risk varies with CA125 level and age. The Ovatools model predicts OC risk based on age and CA125 levels to support primary care triage.

methodsWe evaluated five alternative triage pathways for suspected OC in primary care, using a decision model. Two CA125-USS sequential pathways used Ovatools risk: 1-3% (subsequent USS) and ≥3% (urgent referral), or age-adjusted CA125 thresholds equivalent to Ovatools risks. Three pathways involved concurrent CA125-USS testing, with referral if abnormal USS or one of the following: (1) Ovatools risk ≥3%, (2) CA125 above the equivalent age-adjusted threshold, or (3) CA125 ≥ 35 U/mL. Clinical and cost-effectiveness was compared against current practice for women over and under 50 years.

resultsAll alternative pathways increased benefits at age ≥50 years, at additional cost. The incremental cost-effectiveness ratios for CA125-USS sequential pathways were below £30,000, dropping below £20,000 if the Ovatools threshold for USS increased to 1.2-1.4% risk. DISCUSSION: For women ≥50 years, the Ovatools and equivalent age-adjusted threshold sequential pathways are cost-effective compared to current practice.

Indexed as

CA-125 AntigenEarly Detection of CancerMembrane ProteinsOvarian NeoplasmsTriageAdultAgedAged, 80 and overAge FactorsCost-Benefit AnalysisEnglandFemaleHumansMiddle AgedPrimary Health CareRisk AssessmentCA-125 AntigenMembrane ProteinsMUC16 protein, human

Identifiers

PMID40962845
PMCPMC7618296

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.