Advertisement

How CA 125 is used in routine clinical practice

      Abstract

      The only role where the CA 125 test has proven utility is: (i) for monitoring ovarian cancer (OC); and (ii) for a preoperative test in patients with an ovarian mass. The aim of our study was to assess the clinical indications for CA 125 determinations in order to estimate the appropriateness of CA 125 use. During the period of 1 August 1993 through 31 December 1995 all CA 125 assays performed at the laboratory of the Institut Central des Hôpitaux Valaisans (ICHV) and the data of the patients receiving these tests were audited in order to identify the clinical indication for the test. We have considered as ‘correct indication’ a CA 125 test performed: (i) during follow-up monitoring of patients having an OC and; (ii) as a preoperative test of a suspect ovarian mass. 462 patients have received a total of 1057 CA 125 assays. 84 (18%) patients have received 537 (51%) tests for monitoring OC and 68 (15%) patients, 68 tests (6%) as a preoperative evaluation for an ovarian mass. 310/462 (67%) other patients have received 452/1057 (43%) CA 125 tests for screening purposes in various clinical situations. Therefore, only 33% (152/462) patients including 57% (605/1057) of tests, had CA 125 assessments done for the correct indication. The current pattern of practice shows that a great number of CA 125 requests were inappropriate. Educational actions aimed at laboratory users concerning the optimal use of CA 125 should be considered in order to develop a more rational approach.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Westhoff C
        Current status of screening for ovarian cancer.
        Gynecol. Oncol. 1994; 55: 34-37
        • Jacobs I
        • Davies A.P
        • Bridges J
        • et al.
        Prevalence screening for ovarian cancer in postmenopausal women by CA 125 measurement and ultrasonography.
        Br. Med. J. 1993; 306: 1030-1034
        • Einhorn N
        • Sjovall K
        • Knapp R.C
        • et al.
        Prospective evaluation of serum CA 125 levels for early detection of ovarian cancer.
        Obstet. Gynecol. 1992; 80: 14-18
        • Niloff J.M
        • Klug T.L
        • Schaetzl E
        • et al.
        Elevation of serum CA 125 in carcinomas of the fallopian tube, endometrium and endocervix.
        Am. J. Obstet. Gynecol. 1984; 148: 1057-1058
        • Bast R.C
        • Klug T.L
        • St John E
        • et al.
        A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer.
        N. Engl. J. Med. 1983; 309: 883-887
        • Halila H
        • Stenman U.H
        • Seppala M
        Ovarian cancer antigen CA 125 levels in pelvic inflammatory disease and pregnancy.
        Cancer. 1986; 57: 1327-1329
        • Barbieri R.L
        • Niloff J.M
        • Bast R.C
        • et al.
        Elevated serum concentrations of CA-125 in patients with advanced endometriosis.
        Fertil. Steril. 1986; 45: 630-634
        • Pittaway D.E
        • Fayez J.A
        Serum CA-125 antigen levels increase during menses.
        Am. J. Obstet. Gynecol. 1987; 156: 75-76
        • Past T
        • Ludwig C
        CA 125 — a tumor marker?.
        Schweiz. Med. Wochenschr. 1995; 125: 1195-1200
        • Zurawski Jr., V.R
        • Sjovall K
        • Schoenfeld D.A
        Prospective evaluation of serum CA 125 levels in a normal population, phase I.
        Gynecol. Oncol. 1990; 36: 299-305
        • Jacobs I
        • Bast R.C
        The CA 125 tumor-associated antigen.
        Hum. Reprod. 1989; 4: 1-12
      1. NIH Consensus Conference, ovarian cancer: screening, treatment and follow-up. J Am Med Assoc 1995, 273, 491–497.

        • Rustin G.J
        • Nelstrop A.E
        • Tuxen M.K
        • Lambert H.E
        Defining progression of ovarian carcinoma during follow-up according to CA 125.
        Ann. Oncol. 1996; 7: 361-364
        • American College of Physicians
        Screening for ovarian cancer.
        Ann. Intern. Med. 1994; 121: 141-142
        • Petignat P
        • Vajda D
        • Obrist R
        Utility and limitations of CA 125.
        Schweiz Med. Rund. 1998; 87: 1602-1605
      2. Bilan démographique des communes suisses. Statistique de l'état annuel de la population (ESPOP), 1995, Berne 1996.

        • van der Burg M.E
        • Lammes F.B
        • Verweij J
        The role of CA 125 in the early diagnosis of progressive disease in ovarian cancer.
        Ann. Oncol. 1990; 1: 301-302
        • Kramer S
        • Raff U
        • Jager W
        • Lang N
        CA 125 as an indicator of pleural metastases in breast cancer patients.
        Anticancer Res. 1996; 16: 3165-3168