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Also known as: CA 125 Tumor Marker, CA-125, Cancer Antigen 125, OC125, Ovarian Antigen

Ca 125

The Cancer Antigen 125 (CA-125) test measures the amount of CA-125 in the blood. CA-125 is a protein that is present on the surface of most, but not all, ovarian cancer cells. This makes the test useful as a tumor marker in specific circumstances. Significantly elevated concentrations of CA-125 may be present in the blood of a woman who has ovarian cancer. Small quantities of CA-125 are produced by normal tissues throughout the body and by some other cancers. Levels in the blood may be moderately elevated with a variety of non-cancerous conditions, including menstruation, pregnancy, and pelvic inflammatory disease.
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The CA 125 test contains 1 test with 1 biomarker.

Brief Description: The CA 125 test is a blood test that measures the levels of a protein called cancer antigen 125 (CA 125) in the body. CA 125 is produced by cells lining certain organs, including the ovaries, fallopian tubes, and lining of the uterus. The CA 125 test is primarily used as a tumor marker to aid in the diagnosis, monitoring, and management of certain conditions, particularly ovarian cancer.

Also Known As:  CA 125 Tumor Marker, Cancer Antigen 125 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation is required

When is a CA 125 test ordered?

A CA 125 test may be ordered in the following situations:

  1. Screening and Early Detection of Ovarian Cancer: The CA 125 test is not recommended as a routine screening test for ovarian cancer in the general population. However, it may be considered for women at high risk, such as those with a family history of ovarian cancer or certain genetic mutations. It is important to note that CA 125 levels can be elevated in conditions other than cancer, limiting its specificity for ovarian cancer screening.

  2. Diagnosis and Staging of Ovarian Cancer: A CA 125 test may be ordered if a woman presents with symptoms suggestive of ovarian cancer, such as pelvic pain, bloating, abdominal discomfort, or unexplained weight loss. Elevated CA 125 levels, along with imaging studies and other diagnostic tests, can help support the diagnosis and determine the extent (stage) of the disease.

  3. Monitoring Ovarian Cancer Treatment: After the diagnosis of ovarian cancer, the CA 125 test may be ordered to monitor the effectiveness of treatment and track the response to therapies such as surgery, chemotherapy, or radiation therapy. A decreasing trend in CA 125 levels over time may indicate a positive response to treatment.

  4. Assessment of Ovarian Masses: In cases where an ovarian mass is detected on imaging, a CA 125 test may be ordered to provide additional information. Elevated CA 125 levels can suggest a higher likelihood of the mass being cancerous, although other factors and diagnostic tests are necessary for a definitive diagnosis.

What does a CA 125 blood test check for?

Cancer Antigen 125 is a protein found on the surface of most ovarian cancer cells, but not all. In certain instances, this makes the test useful as a tumor marker. The CA-125 test determines how much CA-125 is present in the blood.

CA-125 concentrations in the blood of an ovarian cancer patient may be significantly increased. As a result, the test could be used to track the success of treatment and/or check for cancer recurrence. However, because not all women with ovarian cancer have increased CA-125, the test may not be appropriate in all circumstances.

Ovarian cancer is the fifth leading cause of death among women. According to the American Cancer Society, a woman's lifetime risk of acquiring ovarian cancer is roughly 1 in 75, with a 1 in 100 chance of dying from it. According to the American Cancer Society, around 22,000 new cases are identified each year in the United States, with approximately 14,000 women dying as a result.

Only around 20% of ovarian tumors are discovered in the early stages before they have progressed beyond the ovary. The signs of ovarian cancer are extremely non-specific, which is one of the main reasons they go unnoticed.

Ongoing research is being driven by the need for a dependable tool for the early identification of ovarian cancer in asymptomatic women. In the meanwhile, it's critical to get frequent physicals and pelvic exams and be aware of your family's medical history and symptoms.

Because CA-125 is non-specific, it is not suggested as a screening test for asymptomatic women. CA-125 is produced in small amounts by normal tissues throughout the body, as well as by some malignancies. A range of non-cancerous diseases, such as menstruation, pregnancy, and pelvic inflammatory disease, can cause somewhat high levels in the blood.

Lab tests often ordered with a CA 125 test:

When a CA 125 test is ordered, it's typically part of a broader evaluation for ovarian cancer or other related health issues. Here are some tests commonly ordered alongside it:

  1. Complete Blood Count (CBC):

    • Purpose: Provides a broad picture of overall blood health.
    • Why Is It Ordered: To assess general health status and to detect signs of infection or anemia, which can accompany cancer or its treatments.
  2. CA 19-9 and CEA (Carcinoembryonic Antigen):

    • Purpose: Tumor markers that can be elevated in other types of cancers, such as gastrointestinal cancers.
    • Why Is It Ordered: To differentiate ovarian cancer from other malignancies, particularly if symptoms or imaging studies suggest gastrointestinal involvement.
  3. Liver Function Test:

    • Purpose: To assess liver health.
    • Why Is It Ordered: To evaluate liver function and to detect liver metastases, which can occur with advanced ovarian cancer.
  4. Kidney Function Test:

    • Purpose: To evaluate kidney function.
    • Why Is It Ordered: To assess overall health, particularly before starting certain cancer treatments that can affect kidney function.
  5. BRCA1 and BRCA2 Genetic Testing:

    • Purpose: To identify mutations in the BRCA1 and BRCA2 genes, which increase the risk of ovarian and breast cancers.
    • Why Is It Ordered: For patients diagnosed with ovarian cancer, particularly if there is a family history of ovarian or breast cancer, as it can impact treatment decisions and cancer risk assessment for family members.

These tests, when ordered alongside a CA 125 test, provide a comprehensive view of a patient’s health status and help in the diagnosis, staging, and monitoring of ovarian cancer. The specific combination of tests will depend on the individual's symptoms, medical history, and the results of initial examinations and tests.

Conditions where a CA 125 test is recommended:

A CA 125 test may be required in the following situations:

  1. Evaluation of Ovarian Masses: When an ovarian mass is detected, a CA 125 test can help assess the likelihood of malignancy. However, it is important to note that CA 125 levels can be elevated in both cancerous and non-cancerous ovarian masses.

  2. Monitoring Ovarian Cancer Treatment: A CA 125 test is used to monitor the response to treatment in patients diagnosed with ovarian cancer and to detect any recurrence or progression of the disease.

  3. Screening for Ovarian Cancer in High-Risk Individuals: In certain high-risk individuals, such as those with a strong family history of ovarian cancer or specific genetic mutations (e.g., BRCA1 or BRCA2), a CA 125 test may be considered as part of a comprehensive screening program. However, the effectiveness of CA 125 as a screening tool is still debated, and other imaging tests and risk assessment tools may be used in conjunction.

How does my health care provider use a CA 125 test?

Health care providers use the results of a CA 125 test in various ways:

  1. Diagnosis and Staging: Elevated CA 125 levels, along with imaging studies and other diagnostic tests, can aid in the diagnosis and staging of ovarian cancer and other gynecological cancers.

  2. Treatment Monitoring: Serial CA 125 tests are performed to monitor the response to ovarian cancer treatment. A decreasing trend in CA 125 levels over time may indicate a positive response to therapy, while increasing levels may suggest disease progression or recurrence.

  3. Risk Assessment and Screening: In high-risk individuals, a CA 125 test, along with other risk assessment tools, may help identify individuals who may benefit from further evaluation or surveillance for ovarian cancer.

  4. Evaluation of Ovarian Masses: CA 125 levels can provide additional information when evaluating ovarian masses, assisting in determining the likelihood of malignancy and guiding further diagnostic and treatment decisions.

It is important to note that CA 125 levels can be influenced by factors other than cancer, and the interpretation of results should be done in consultation with a qualified health care provider who can consider the individual's medical history, symptoms, and other diagnostic findings to make an accurate assessment and provide appropriate recommendations.

What do my CA 125 test results mean?

If CA-125 levels drop throughout treatment, it usually means that the malignancy is responding to it. If CA-125 levels increase or remain unchanged, the cancer may not be responding to treatment. CA-125 values that are elevated after therapy may suggest that the cancer has returned.

If a woman has been diagnosed with ovarian cancer and has a normal baseline CA-125 level, the test is unlikely to be beneficial in monitoring her illness. CA-125 is not a suitable predictor of disease development in this scenario because the ovarian cancer may not be making it.

A considerably raised CA-125 is concerning in a woman with a pelvic mass or in a woman who has a high risk of developing ovarian cancer, but it does not always imply ovarian cancer. This discovery would lead to more testing and evaluation.

Most Common Questions About the CA 125 test:

Understanding the CA 125 Test

What is the CA 125 test?

The CA 125 test is a blood test that measures the amount of cancer antigen 125 (CA 125) in the blood. CA 125 is a protein that is often present in higher concentrations in ovarian cancer cells.

Why is the CA 125 test performed?

The CA 125 test is often performed to monitor ovarian cancer treatment, detect a recurrence, or sometimes to assess if a woman has a higher risk of ovarian cancer. It is not commonly used for routine screening due to its low specificity.

Interpreting CA 125 Levels

What are normal CA 125 levels?

In premenopausal women, a CA 125 level below 35 units/mL is generally considered normal, while for postmenopausal women, a level below 20 units/mL is typically seen as normal. However, these values can vary based on the laboratory.

Does a high CA 125 level always indicate ovarian cancer?

No, a high CA 125 level doesn't always indicate ovarian cancer. Other conditions, such as endometriosis, pelvic inflammatory disease, liver disease, and even pregnancy, can also cause elevated CA 125 levels.

Does a normal CA 125 level rule out ovarian cancer?

No, a normal CA 125 level does not completely rule out ovarian cancer. Some women with ovarian cancer may not have elevated CA 125 levels. Also, the levels can vary over time and from person to person.

CA 125 and Ovarian Cancer

Why is the CA 125 test not commonly used as a routine screening test for ovarian cancer?

The CA 125 test is not commonly used as a routine screening test for ovarian cancer due to its low sensitivity and specificity. This means the test may produce false positives (suggesting cancer when it is not present) and false negatives (failing to detect cancer when it is present).

How is the CA 125 test used in the treatment of ovarian cancer?

During the treatment of ovarian cancer, the CA 125 test is used to monitor the effectiveness of treatment. A decrease in CA 125 levels often indicates that the treatment is working.

Can the CA 125 test detect recurrence of ovarian cancer?

Yes, an increase in CA 125 levels can suggest a recurrence of ovarian cancer, often before symptoms appear. However, all other potential causes for the rise need to be investigated.

CA 125 and Other Health Conditions

Can the CA 125 test be used for other types of cancer?

While CA 125 is most commonly associated with ovarian cancer, elevated levels can also be found in other types of cancer such as cancers of the uterus, cervix, pancreas, liver, colon, breast, lung, and digestive tract.

What non-cancerous conditions can raise CA 125 levels?

Non-cancerous conditions that can raise CA 125 levels include endometriosis, pelvic inflammatory disease, liver disease, menstruation, pregnancy, and certain types of chest infections.

Other Considerations

How do CA 125 levels change with age?

Age does not generally affect CA 125 levels. However, menopausal women typically have a lower upper limit for what's considered normal.

Can lifestyle factors influence CA 125 levels?

There is no concrete evidence to suggest that lifestyle factors significantly influence CA 125 levels. However, certain conditions linked to lifestyle, such as liver disease, can affect CA 125 levels.

Can certain medications affect CA 125 levels?

Certain medications, particularly those used in the treatment of ovarian cancer, are designed to lower CA 125 levels. If you're undergoing treatment, your doctor will interpret your CA 125 levels in the context of your treatment plan.

How do CA 125 levels vary during the menstrual cycle?

CA 125 levels can slightly increase during menstruation but typically remain within the normal range.

Is the CA 125 test used in the diagnosis and management of endometriosis?

While elevated CA 125 levels can be associated with endometriosis, the test is not specific enough to diagnose the condition. It may be used in conjunction with other diagnostic methods and to track the response to endometriosis treatment.

The CA 125 Test and Other Tests

How does the CA 125 test relate to other tumor marker tests?

Like other tumor markers, CA 125 levels can provide valuable information about cancer presence and progression. However, it's not definitive, and it's usually used in conjunction with other diagnostic tools.

Is the CA 125 test used in conjunction with imaging studies?

Yes, in the context of ovarian cancer, the CA 125 test is often used in conjunction with imaging studies like ultrasound, CT, or MRI to assess the presence and spread of the disease.

Are there other markers for ovarian cancer besides CA 125?

Yes, another biomarker called HE4 (human epididymis protein 4) is also used in some cases. In addition, the ROMA (Risk of Ovarian Malignancy Algorithm) test combines CA 125 and HE4 levels to assess ovarian cancer risk.

How does the CA 125 test compare with the transvaginal ultrasound in detecting ovarian cancer?

The CA 125 test and transvaginal ultrasound are often used together to detect ovarian cancer. CA 125 is a blood test that measures a protein, while a transvaginal ultrasound is an imaging test that visually examines the ovaries.

How does the CA 125 test compare to the BRCA gene test for ovarian cancer risk?

The CA 125 test and BRCA gene test serve different purposes. The BRCA gene test looks for mutations in the BRCA1 and BRCA2 genes, which significantly increase the risk of breast and ovarian cancer. The CA 125 test measures a protein that may be elevated in ovarian cancer.

Future of CA 125 Testing

Are there ongoing efforts to improve the accuracy of the CA 125 test?

There is ongoing research to find new biomarkers that could be used in combination with CA 125 to improve the accuracy of ovarian cancer detection.

Are there new technologies that might replace the CA 125 test in the future?

New technologies are being developed for earlier and more accurate detection of ovarian cancer, including liquid biopsy and more advanced imaging techniques. However, these are still under research and are not yet routinely used.

Could genetic testing influence how the CA 125 test is used in the future?

As genetic testing becomes more commonplace, it could influence how the CA 125 test is used. For example, women with BRCA gene mutations may be monitored more closely with CA 125 testing.

How might advances in personalized medicine affect the use of the CA 125 test?

As personalized medicine advances, the CA 125 test might be used more selectively, based on an individual's unique genetic profile and risk factors.

Could the CA 125 test ever be used as a universal screening tool for ovarian cancer?

Currently, the CA 125 test is not recommended as a universal screening tool due to its low sensitivity and specificity. However, if advancements in technology and research improve its accuracy, it could potentially be used in this way in the future.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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