The mortality of ovarian cancer is higher than any other female genital malignant tumors, while there exists a strong correlation between early-stage detection and cure for it. CA125 and HE4 are two most common and ef...The mortality of ovarian cancer is higher than any other female genital malignant tumors, while there exists a strong correlation between early-stage detection and cure for it. CA125 and HE4 are two most common and effective serum markers in recent screening research of ovarian cancer. This paper derives a sequential screening strategy for ovarian cancer by jointly modeling the longitudinal profiles of CA125 and HE4. We construct a Bayesian hierarchical mixture model with changepoint, and propose two approaches for diagnosis: the risk of cancer index and the hypothesis test on the true incidence time. We simulated a 7-year sequential screening research and compared with the standard approach based on a fixed cutoff level. Our approach achieves a 15% higher sensitivity for a fixed specificity, indicating that the sequential strategy combining multiple markers is more effective in the early-stage detection of ovarian cancer.展开更多
基金Supported by the the National Natural Science Foundation of China(Grant No.11171007)Ph.D. Programs Foundation of Ministry of Education of China(No.20090001110005)
文摘The mortality of ovarian cancer is higher than any other female genital malignant tumors, while there exists a strong correlation between early-stage detection and cure for it. CA125 and HE4 are two most common and effective serum markers in recent screening research of ovarian cancer. This paper derives a sequential screening strategy for ovarian cancer by jointly modeling the longitudinal profiles of CA125 and HE4. We construct a Bayesian hierarchical mixture model with changepoint, and propose two approaches for diagnosis: the risk of cancer index and the hypothesis test on the true incidence time. We simulated a 7-year sequential screening research and compared with the standard approach based on a fixed cutoff level. Our approach achieves a 15% higher sensitivity for a fixed specificity, indicating that the sequential strategy combining multiple markers is more effective in the early-stage detection of ovarian cancer.