What CA-125 level is suspicious for ovarian cancer?

CA-125 >35 U/mL is the standard upper limit. In premenopausal women, CA-125 is less specific (elevated in endometriosis, fibroids, PID). Postmenopausal women with CA-125 >35 and a pelvic mass have 70-80% positive predictive value for malignancy.

What is the ROMA score?

ROMA (Risk of Ovarian Malignancy Algorithm) = CA-125 + HE4 + menopausal status. ROMA >26.4% (premenopausal) or >27.7% (postmenopausal) = high risk for malignancy. ROMA has better specificity than CA-125 alone.

When is risk-reducing salpingo-oophorectomy recommended for BRCA carriers?

BRCA1 carriers: RRSO recommended at 35-40 years. BRCA2 carriers: at 40-45 years. RRSO reduces ovarian cancer risk by >90% and breast cancer risk by 50% when performed before natural menopause.

Ovarian Cancer CA-125 and BRCA Risk Assessment

Interpret CA-125 levels with Risk of Ovarian Malignancy Algorithm (ROMA) incorporating HE4 and menopausal status. Identify BRCA1/BRCA2 mutation carriers for genetic counseling and risk-reducing salpingo-oophorectomy.

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Frequently Asked Questions

What CA-125 level is suspicious for ovarian cancer?

What is the ROMA score?

When is risk-reducing salpingo-oophorectomy recommended for BRCA carriers?