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These substances, also called biomarkers, can be measured using blood tests. But a high level of one of these tumor markers does not necessarily mean you have ovarian cancer.
Doctors do not use blood tests for tumor markers to screen people with an average risk of ovarian cancer. But they are useful in evaluating ovarian cancer treatment and checking for disease progression or recurrence.
There are many different types of tests for ovarian tumor markers. Each test looks for a different type of biomarker.
Cancer antigen 125 (CA-125) is a protein that is the most widely used tumor marker for ovarian cancer. According to the Ovarian Cancer Research Consortium, more than 80 percent of women with advanced ovarian cancer and 50 percent of women with early-stage ovarian cancer have elevated blood levels of CA-125.
According to the National Cancer Institute (NCI), the typical range is 0 to 35 units per milliliter. Levels above 35 may indicate the presence of ovarian tumors.
Human epididymal protein 4 (HE4) is another tumor marker. It is often overexpressed in epithelial ovarian cancer cells, which are cells in the outer layer of the ovary.
Small amounts of HE4 can also be found in the blood of people without ovarian cancer. This test can be used in conjunction with the CA-125 test.
Cancer antigen 19-9 (CA19-9) is elevated in some types of cancer, including pancreatic cancer. Less commonly, it is associated with ovarian cancer. It can also indicate benign ovarian tumors or other benign conditions.
You can also stay healthy and still have a small amount of CA19-9 in your blood. This test is not commonly used to detect ovarian cancer.
In a 2017 report, physicians wrote that the use of this tumor marker to predict ovarian cancer should be avoided because it may cause concern rather than a definitive diagnosis.
Some types of gastrointestinal and gynecological cancers are associated with high levels of cancer antigen 72-4 (CA72-4). But it is not an effective tool for diagnosing ovarian cancer.
Some other tumor markers may indicate the presence of germ cell ovarian cancer. Germ ovarian cancer occurs in the germ cells, which are the cells that become an egg. These marks include:
Tumor markers alone do not confirm the diagnosis of ovarian cancer. Doctors use ovarian cancer markers and other tests to help make a diagnosis.
CA-125 is the most commonly used tumor marker for ovarian cancer. But if your CA-125 levels are typical, your doctor may test for HE4 or CA19-9.
If you have signs or symptoms of ovarian cancer, your doctor may start with a physical exam. Your personal and family medical history also plays a role. Based on these findings, the next steps may include:
Once ovarian cancer is diagnosed, tumor markers can help in treatment. These tests can establish baseline levels for some tumor markers. Regular tests can reveal whether levels of tumor markers are rising or falling. This indicates whether the treatment is working or if the cancer is progressing.
These tests can also help control recurrence, which means how long after treatment the cancer returns.
Screening tests are used to detect cancer in people without symptoms. None of the available tumor marker tests are reliable enough to screen people at moderate risk for ovarian cancer.
For example, not all ovarian cancer patients have elevated CA-125 levels. According to the Ovarian Cancer Research Consortium, a CA-125 blood test can miss half the cases. There are several benign causes of elevated CA-125 levels.
The combination of CA-125 and HE4 may be useful in screening high-risk ovarian cancer groups. But these tests do not definitively diagnose ovarian cancer.
The United States Preventive Services Task Force (USPSTF) does not currently recommend routine screening by any method for people who are asymptomatic or at high risk for ovarian cancer. Researchers are looking for more accurate ways to detect this condition.
Tumor markers for ovarian cancer may help screen people at high risk for ovarian cancer. But blood tests alone are not enough to make a diagnosis.
Tumor markers for ovarian cancer can help evaluate the effectiveness of treatment and detect the progression of the disease.
According to a 2019 review, more than 70% of ovarian cancers are at an advanced stage at the time of diagnosis. Research is ongoing, but there is currently no reliable screening test for ovarian cancer.
That’s why it’s especially important to be aware of warning signs and report them to your doctor. If you think you’re at high risk for ovarian cancer, ask your doctor what tests might help you and if there are ways to lower your risk.
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