{
  "abstract": "Importance Two randomized trials have shown that screening with CA-125 is not of value for reducing ovarian cancer mortality. This appears to be because changes in CA-125 occur too late in the disease process to allow for surgical cure of early-stage disease. Objective To determine whether glycovariants of CA-125 could detect ovarian cancer years before clinical diagnosis. Design Case-control study of cryopreserved blood samples and data from the population-based Malmö Diet and Cancer cohort. Setting Population-based study in Sweden. Participants Serum was available for 17,297 women aged 44 – 73 collected at baseline in 1991-1996 and from 2,168 women re-sampled in 2007-2012. Participants’ records were linked to the Swedish cancer registry to identify 82 women with incident ovarian cancer diagnosed up to 10 years after blood draw. Cases were matched 1:3 with controls by age and venipuncture date. Exposure Serum was measured for CA-125 glycovariants Sialyl-Thomsen-nouveau (STn) and Macrophage-Galactose-Lectin (MGL) using GLYVAR ® Ovarian I and II assays (Uniogen), conventional CA-125 (CanAg CA125 EIA, Fujirebio) and HE4 EIA (Fujirebio). Main outcome measure Ovarian cancer. Results The CA-125-STn was associated with subsequent ovarian cancer (p=0.002). In the primary analysis restricted to cases within 5 years, the area-under-the-curve for CA-125-STn was 0.68; with moving window analysis suggesting retained predictiveness up to 5-7 years. Of the cases diagnosed within 5 years, 27% were in the top 5% of CA-125-STn levels (≥2.3 U/ml), with 35% and 49% of cases diagnosed in the top 10% and 20% respectively. Our findings were replicated by independent measurements of a separate aliquot from a subset of cases and controls. Neither CA-125, HE4 nor CA-125 glycovariants detected by MGL importantly predicted subsequent ovarian cancer. Conclusions and Relevance CA-125-STn can detect ovarian cancer several years before clinical diagnosis. Further research is warranted on larger cohorts with sequential samples to determine the shape of the relationship between CA-125-STn and risk, the value of longitudinal sampling of CA-125-STn, and whether other markers could be combined with CA-125-STn to more accurately predict ovarian cancer risk. Key Points Question Can glycovariants of CA-125 detect ovarian cancer years before clinical diagnosis? Findings In a case-control study of 323 Swedish women followed longitudinally, the Sialyl-Thomsen-nouveau (STn) glycovariant of CA-125, but not conventional CA-125 or other markers, predicted ovarian cancer. Close to half of ovarian cancer cases within 5 years of blood sample occurred in the patients with the top 20% of CA-125-STn glycovariant levels. Meaning CA-125-STn can detect ovarian cancer several years before clinical diagnosis.",
  "abstract_shown": true,
  "affiliations": [
    "Memorial Sloan Kettering Cancer Center"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "A. J. Vickers"
    },
    {
      "name": "O. Melander"
    },
    {
      "name": "K. Long Roche"
    },
    {
      "name": "K. Kuningas"
    },
    {
      "name": "M. Helle"
    },
    {
      "name": "K. Huhtinen"
    },
    {
      "name": "L. Kokko"
    },
    {
      "name": "A. Dahlin"
    },
    {
      "name": "H. Lilja"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dkrkaqsx8pm9m.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.11.26362728",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362728v1.full",
  "id": "dkrkaqsx8pm9m",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362728v1",
  "language": null,
  "licence": "PDM-1.0",
  "licence_label": "Public domain",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/publicdomain/mark/1.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "oncology"
    ],
    [
      "openalex",
      "2743|Ovarian cancer diagnosis and treatment"
    ]
  ],
  "openalex": "W7213331032",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362728v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-11",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dkrkaqsx8pm9m.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:35Z",
      "native_id": "10.64898/2026.09.11.26362728",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.11.26362728v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:oncology",
      "subfield": "oncology"
    }
  ],
  "title": "Glycovariants of CA-125 in the early detection of ovarian cancer",
  "title_text": "Glycovariants of CA-125 in the early detection of ovarian cancer",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:35Z",
  "url": "https://research.draconitic.com/paper/dkrkaqsx8pm9m",
  "venue": "medRxiv",
  "versions": []
}