These results indicate that the amount of CA125 in the serum is a good marker for detecting early stages of ovarian cancer and in particular for the evaluation of anticancer drugs.
These recommendations may be summarized as follows: 1) site-specific ovarian carcinoma: screening with physical examination, CA 125, and ultrasound, and bilateral oophorectomy after childbearing has been completed; 2) breast/ovary syndrome: screening for ovarian cancer as above, mammography and bilateral oophorectomy as above, and possible prophylactic mastectomy; and 3) Lynch Cancer Family Syndrome: screening for ovarian cancer as above, colonoscopy and endometrial biopsy, and prophylactic hysterectomy and bilateral oophorectomy once childbearing is complete.
We concluded that a prescreening immunochemical test based on the measurement of serum CA 125 (with a threshold value of > or = 20 U/ml) would increase the prior odds for familial ovarian cancer by 2.8, but would lower the overall detection rate by 29% at the prevalence screening.
CA-125, the most widely used biomarker for ovarian cancer, does not have a high positive predictive value and it is only effective when used in combination with other diagnostic tests.
Blinded studies on sera from postmenopausal patients with ovarian carcinoma and controls indicate that the specificity and sensitivity of the HE4-based ELISA is equivalent to that of the CA125 assay.
Screening for early-stage disease with individual serum tumor markers, such as CA125, is limited by the fact that no single marker is up-regulated and shed in adequate amounts by all ovarian cancers.
Women with family histories suggestive of an increased risk of ovarian carcinoma who have not had a deleterious BRCA1 or BRCA2 mutation identified are commonly suggested to consider ovarian carcinoma screening with transvaginal ultrasound and/or assessment of CA 125 levels.
This study evaluates the accuracy of transvaginal ultrasound (TVUS) in combination with CA125 to detect ovarian cancer in women at hereditary risk for ovarian cancer.
To evaluate positive predictive values of CA 125 or transvaginal ultrasonography screening for ovarian cancer according to family history of breast or ovarian cancer.
Premenopausal women should be referred if the CA 125 is elevated above 200 U/mL, there is an evidence of metastatic disease or ascites, or strong family history of breast or ovarian cancer.