Indications
1. Postmenopausal pelvic mass evaluation
2. Ovarian Cancer serial monitoring
3. Not a Screening Test for cancer (insensitive)
  1. May obtain baseline if Ovarian Cancer high risk
Interpretation (CA 125 level in units/ml)
1. Normal: CA-125 less than 35 (Does not exclude cancer)
2. Increased
  1. CA-125 >35 highly correlated with cancer
  2. CA-125 >65 associated with cancer in 90% pelvic mass
  3. CA-125 >200 unlikely to be due to benign condition
Efficacy
1. Not specific (see causes of increased CA-125 below)
2. Not sensitive
  1. Normal in 50% of Stage I Ovarian Cancer
  2. Increased in 85% of Ovarian Cancer overall
Increased CA-125 Causes
1. Non-Cancer Causes
  1. Endometriosis
  2. Pelvic Inflammatory Disease
  3. Uterine Fibroids
  4. Pregnancy
  5. Liver Cirrhosis
  6. Post-Menopause
  7. Tuberculous Peritonitis
  8. Pelvic Irradiation
2. Malignant Causes
  1. Ovarian Cancer
  2. Liver Cancer
  3. Lung Cancer
  4. Breast Cancer
  5. Colon Cancer
  6. Pancreatic Cancer
  7. Endometrial Cancer
  8. Cervical Cancer
References
1. Tuxen (1995) Cancer Treat Rev 21:215
2. Jacobs (1999) Lancet 353:1207

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