August 31, 2020 - CA-125 stands for Cancer Antigen 125 and is a protein that can be found in higher levels in the blood of women who have ovarian cancer. CA-125 is released into the bloodstream after being produced on the cell surfaces. In about three-quarters of women who have advanced ovarian cancer, the CA-125 will be elevated, and in about half of those with early-stage ovarian cancer, the CA-125 will be elevated. As you can see, while a CA-125 screening test could be useful, it is certainly not without its problems since it can miss half of all early ovarian cancers.
Other Reasons CA-125 Can Be Elevated - CA-125 can also be elevated by benign conditions, including uterine fibroids, pregnancy, cirrhosis of the liver, endometriosis, and diverticulitis, therefore, a woman could easily receive a false positive result from a CA-125 test. Because of this, the U.S. Preventative Services Task Force and the National Cancer Institute do not endorse the CA-125 test to screen those who are considered at “ordinary” risk of ovarian cancer.
CA-125 Test Approved as a Screening Test to Detect Recurrence or to Monitor Treatment - The FDA has approved the CA-125 screening test to detect a recurrence of ovarian cancer following treatment or to monitor the effectiveness of a particular ovarian cancer treatment. The CA-125 test is often used in conjunction with CT scans. Overall, the CA-125 screening test is most accurate among post-menopausal women who have a pelvic mass. So, while a CA-125test can be a useful tool, it is not at all uncommon for the CA-125 count to be elevated in premenopausal women as a result of a benign condition such as those listed above.
No Current Tools or Approaches are Effective in Diagnosing Ovarian Cancer - Unfortunately, there are no currently available tools or approaches that are effective in diagnosing ovarian cancer. In fact, studies have found that screening women who are considered to be at average risk of ovarian cancer failed to improve their odds of surviving ovarian cancer—and could actually place them at greater risk, due to the complications possible from unnecessary surgical procedures.
When a physician suspects a woman has ovarian cancer, an exploratory surgical procedure, known as a laparotomy, is required to definitively diagnose the disease. During the laparotomy, an incision is made, cysts or other suspicious areas are removed and biopsied, and the surgeon will assess the abdominal cavity fluids and cells. If the lesion is cancerous, surgical staging will be done to determine how far the cancer has spread.
Results of CA-125 Screening in a Clinical Trial - A clinical trial involving 78,000 women were randomized between screening protocols involving annual CA-125 testing for six years and a transvaginal ultrasound for four years, and those who received “normal” care. The study followed the women for 13 years, determining that while more women in the screening protocols were diagnosed, more who underwent those protocols died of ovarian cancer. Further, more than 3,000 women underwent surgical procedures based on false- positive results, with 160 of those suffering serious complications from the surgery.
CA-125 Not Recommended for Women with an Average Ovarian Cancer Risk - To conclude, the cancer antigen 125 blood test is not recommended for women with an average risk of ovarian cancer. Women who have a high risk of ovarian cancer, including those with mutations in the BRCA1 or BRCA2 genes, might consider periodic CA-125 testing, however, there remains disagreement in the medical community regarding the usefulness of the test.
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