Influence of Pre-treatment CA 125 Levels on Survival Outcomes Across Ethnic Groups in Ovarian Cancer Patients

Aim This study evaluates demographics, clinicopathological features, and mortality influencers among 16,466 US patients with ovarian cancer diagnosed between 2010 and 2017, focusing on CA 125 levels and racial disparities affecting outcomes. Methods We analyzed SEER data for 16,466 patients diagnosed from 2010 to 2017. Demographic, clinical, overall mortality (OM), and cancer-specific mortality (CSM) variables were assessed. Factors with P < 0.1 on univariate Cox regression were entered into multivariate Cox models to identify independent prognostic factors, with hazard ratios greater than one indicating adverse prognosis. Results Among 16,466 patients with ovarian cancer diagnosed between 2010 and 2017, most were aged 40–79 years and presented with distant-stage disease. The majority of patients were non-Hispanic White, followed by Hispanic and non-Hispanic Black patients. Serous carcinoma was the most common histologic subtype, and most tumors were poorly differentiated or undifferentiated. Multivariate analysis identified age, marital status, tumor stage, race, tumor subtype, tumor grade, CA-125 level, chemotherapy, and surgery as significant predictors of survival. Hispanic patients with borderline CA-125 levels demonstrated higher mortality risk, whereas elevated CA-125 levels were not significantly associated with increased mortality among non-Hispanic Black patients. Conclusion These findings emphasize early detection, personalized treatment, and social support to improve outcomes. Persistent racial disparities, independent of CA 125 levels, highlight the need for targeted research and interventions. This study adds to existing literature and supports continued efforts to enhance screening, treatment, and supportive care for ovarian cancer patients, particularly to address inequities in survival nationwide. Future studies should integrate biomarker stratification with equity-focused clinical strategies.