Ovarian Cancer

Order the ovarian cancer tests to check for a substance called CA125 that is produced by some ovarian cancer cells. A high level of CA125 in your blood could be a sign of ovarian cancer. Take control and learn about your health with Ulta Lab Tests.

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The CA 125 level can provide prognostic information in the follow-up management of patients with ovarian carcinoma. The assay should be used as an adjunctive test in the management of ovarian cancer patients. CA 125 is not recommended as a cancer screening procedure to detect cancer in the general population

CA 125 is used as an aid in monitoring the response to therapy for patients with epithelian ovarian cancer and in detecting residual ovarian cancer in patients who have undergone therapy. HAMA pre-treatment inhibits possible heterophilic interference.

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Increased serum CEA levels have been detected in persons with primary colorectal cancer and in patients with other malignancies involving the gastrointestinal tract, breast, lung, ovarian, prostatic, liver and pancreatic cancers. Elevated serum CEA levels have also been detected in patients with nonmalignant disease, especially patients who are older or who are smokers. CEA levels are not useful in screening the general population for undetected cancers. However, CEA levels provide important information about patient prognosis, recurrence of tumors after surgical removal, and effectiveness of therapy.

Inhibins are heterodimeric protein hormones secreted by granulosa cells of the ovary in females and Sertoli cells of the testis in males. Inhibins selectively suppress the secretion of pituitary follicle-stimulating hormone (FSH) and also have local paracrine actions in the gonads. In females, inhibin A is primarily produced by the dominant follicle and corpus luteum, whereas inhibin B is primarily produced by small developing follicles. Serum inhibin A and B levels fluctuate during the menstrual cycle. Inhibin A is low in the early follicular phase and rises at ovulation to maximum levels in the midluteal phase.

Inhibin-B is the major circulating inhibin in males and can be used as endocrine marker of spermatogenesis in subfertile men. In the female, since Inhibin-B decreases to undetectable levels after normal menopause, certain ovarian cancers (mucinous carcinomas, granulosa cell tumors) continue to produce inhibin after menopause, Inhibin-B can serve as a regular screening test in the female, especially in post-menopausal women.

This assay is intended for use in the assessment of risk for the development of hepatocellular carcinoma (HCC) in patients with chronic liver disease.

The OVA1® Test is an aid to further assess the likelihood that malignancy is present when the physician's independent clinical and radiological evaluation does not indicate malignancy. The OVA1® Test is a qualitative serum test that combines the results of five immunoassays into a single numerical result. It is indicated for women who meet the following criteria: over age 18, ovarian adnexal mass present for which surgery is planned, and not yet referred to an oncologist. The test is not intended as a screening or stand-alone diagnostic assay, or for patients with a diagnosis of malignancy within the last 5 years, or to determine whether a patient should proceed to surgery. Samples that contain rheumatoid factor ?250 IU/mL cannot be used in the OVA1® Test. Triglyceride levels above 4.5 g/L may interfere with the assay and should not be used in the OVA1® Test.

The OVA1® Test is an aid to further assess the likelihood that malignancy is present when the physician's independent clinical and radiological evaluation does not indicate malignancy. The OVA1® Test is a qualitative serum test that combines the results of five immunoassays into a single numerical result. It is indicated for women who meet the following criteria: over age 18, ovarian adnexal mass present for which surgery is planned, and not yet referred to an oncologist. The test is not intended as a screening or stand-alone diagnostic assay, or for patients with a diagnosis of malignancy within the last 5 years, or to determine whether a patient should proceed to surgery. Samples that contain rheumatoid factor ?250 IU/mL cannot be used in the OVA1® Test. Triglyceride levels above 4.5 g/L may interfere with the assay and should not be used in the OVA1® Test.

ROMA™ (Risk of Ovarian Malignancy Algorithm)


CA125, HE4 Ovarian CA Monitoring, and Risk of Ovarian Malignancy calculation

Clinical Significance

The risk of Ovarian Malignancy Algorithm (ROMA™) test is intended to aid in assessing the risk of ovarian cancer in women with a pelvic mass based on the patient's HE4 and CA125 levels, and their menopausal status. Women with ROMA™ levels above the cutoff have an increased risk of ovarian cancer. ROMA™ must be interpreted in conjunction with an independent clinical and radiological assessment.

The ROMA™ test is indicated for women who meet the following criteria:
over age 18; presence of an ovarian pelvic mass for which surgery is planned; and not yet referred to an oncologist.

The CA125 and HE4 tests are performed using the Abbott ARCHITECT i2000SR unit. The values obtained with different assay methods cannot be used interchangeably due to differences in assay methods and reagent specificity.

The test is not intended as a screening stand-alone diagnostic or tumor monitoring assay. Tumor monitoring using HE4 and/or CA125 should be ordered separately.

The ROMA value is the result of a computation based on the HE4 and CA125 values observed.
1. Moore RG, et al. A novel multiple marker bioassay utilizing HE4 and CA 125 for the prediction of ovarian cancer in patients with a pelvic mass. Gynecol Oncol 2009; 112:40-6.


This test detects mutations in the BRCA1 and BRCA2 genes which are the most common causes of hereditary breast and ovarian cancers.

This test is specific for hCG beta subunit and offers sensitivity necessary to detect pregnancy as early as ten days post conception.

This test should be used only to determine pregnancy.

hCG may reach detectable limits within 7-10 days of conception. hCG is produced by the placenta and reaches a peak between the 7th and 10th week of gestation. hCG is a glycoprotein hormone produced by the syncytiotrophoblast of the placenta and secreted during normal pregnancy and with pathologic conditions such as hydatidiform mole, choriocarcinoma and testicular neoplasm. Order hCG, Total, Qualitative, Urine, if hCG serum result is inconsistent with clinical presentation.

Lactate Dehydrogenase (LD) (LDH)

Elevations in serum lactate dehydrogenase occur from myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary emboli, malignancies, and muscular dystrophy

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CA 15-3 may be useful for monitoring patients with metastatic breast cancer and certain ovarian cancers. The CA 15-3 values from sequential samples have a high correlation with the clinical course in most patients with metastatic breast cancer.

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Measuring the circulating levels of estradiol is important for assessing the ovarian function and monitoring follicular development for assisted reproduction protocols. Estradiol plays an essential role throughout the human menstrual cycle. Elevated estradiol levels in females may also result from primary or secondary ovarian hyperfunction. Very high estradiol levels are found during the induction of ovulation for assisted reproduction therapy or in pregnancy. Decreased estradiol levels in females may result from either lack of ovarian synthesis (primary ovarian hypofunction and menopause) or a lesion in the hypothalamus-pituitary axis (secondary ovarian hypofunction). Elevated estradiol levels in males may be due to increased aromatization of androgens, resulting in gynecomastia.

IMPORTANT - Note this Estradiol test is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute in Estradiol, Ultrasensitive LC/MS/MS - #30289 at an additional charge of $34

Estrogens are a group of steroids that regulate the menstrual cycle and function as the main female sex hormones. The most common forms of estrogens tested are estrone (E1), estradiol (E2), and estriol (E3). Estrogens are responsible for the development of female sex organs and secondary sex characteristics and are tied to the menstrual cycle and pregnancy. They are considered the main sex hormones in women and are present in small quantities in men. E1 and E2 are the two main estrogens in non-pregnant females.Estrone (E1) is derived from metabolites from the adrenal gland and is often made in adipose tissue (fat). Estrone can be converted into estrdiol or estriol when needed. Estrone is present in small amounts in children prior to puberty and then increases slightly at puberty for both males and females. While levels remain constant in adult males, it will increase and fluctuate for females during the menstrual cycle. After menopause, it becomes the major estrogen, with E2 and E3 levels diminishing greatly.Estradiol (E2) is the predominant form and is produced primarily in the ovaries with additional amounts produced by the adrenal glands in women and in the testes and adrenal glands in men. In menstruating women, levels vary throughout the month, rising and falling in concert with FSH (follicle-stimulating hormone), LH (luteinizing hormone), and progesterone as follicles are stimulated in the ovaries, an egg is released, and the uterus prepares for a potential pregnancy. The level is lowest at the beginning of the menstrual cycle and rise to their highest level just before the release of an egg from the ovary (ovulation). Normal levels of estradiol provide for proper ovulation, fertilization of the egg (conception), and pregnancy, in addition to promoting healthy bone structure and regulating cholesterol levels.

The placenta converts DHEA-S produced by the fetal adrenals to Estriol and other estrogens. Estriol is useful in assessing the fetal adrenals and placenta during pregnancy. More commonly, Estriol is one of the maternal serum biochemical markers used to screen for common chromosomal trisomies, especially Down syndrome.

Estrogens are secreted by the gonads, adrenal glands, and placenta. Total estrogens provide an overall picture of estrogen status for men and women.

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Estrone is primarily derived from metabolism of androstenedione in peripheral tissues, especially adipose tissues. Individuals with obesity have increased conversion of androstenedione to Estrone leading to higher concentrations. In addition, an increase in the ratio of Estrone to Estradiol may be useful in assessing menopause in women.

Helpful in assessing testicular function in prepubescent hypogonadal males and in managing hirsutism, virilization in females

This is an uncapped test. Reference ranges above 1100 ng/dL can be reported with a quantitative result.

Helpful in assessing testicular function in male and managing hirsutism, virilization in females.

It can be hard to catch ovarian cancer in its early stages. One of the best ways to diagnose it is to have ovarian cancer tests run in a laboratory.

If you or a loved one have been suffering from the symptoms of ovarian cancer, have a family history, or you've been diagnosed and want to check on your treatment, it's a good idea to get yourself tested.

If you're looking for more information about ovarian cancer lab tests and how they can help, read on.

What is Ovarian Cancer?

Ovarian cancer is an uncontrolled cell growth in a woman's reproductive system, originating within the ovaries. The ovaries are responsible for regulating estrogen and progesterone hormones, and releasing an egg cell during a woman's monthly cycle.

There are three main types of ovarian cancer, based on where the abnormality originates. The most common type is epithelial tumors, where the cells grow in excess on the outer surface of the ovaries.

Less than two percent of ovarian cancer results from germ cell tumors, which start as egg cells or the cells that produce them. The last type, stromal tumors, originate in the connective tissue or cells that regulate hormones, and are very rare.

How Do They Check for Ovarian Cancer?

A doctor may do a physical exam, ultrasound test, or bloodwork (such as the CA-125 cancer marker test) to determine if you have ovarian cancer. For many types of ovarian cancer, it is impossible to determine whether the tumor is malignant, borderline, or benign until after you have had it removed and/or had a biopsy.

Causes and Risk Factors

The causes for developing ovarian cancer are still unknown. Research is ongoing to determine possible causes or links between ovarian cancer and ovulation or an egg cell's release. Genetic changes and mutations that cause ovarian cancer are still being studied.

Risk factors for developing epithelial ovarian cancer include age, being overweight or obese, never having a full pregnancy or getting pregnant past 35 years of age, taking hormone therapy, having a family history of cancer, having a fertility treatment such as in-vitro fertilization, smoking, and having breast cancer.

Signs and Symptoms

Some common warning signs and symptoms of ovarian cancer include:

  • Bloating or feeling full too quickly
  • Abdominal or pelvic pain
  • Problems with urination such as needing to go often or badly
  • Constipation
  • Pain during sex
  • Back pain
  • Upset stomach
  • Fatigue
  • Changes in menstrual cycle

It's important to note that many women with early ovarian cancer do not have symptoms. Besides that, many of the symptoms are fairly common or could not be linked to ovarian cancer.

If you or a loved one are experiencing a combination of these ovarian cancer symptoms, it's a good idea to get a screening test just to be safe. It is less likely to get an ovarian cancer diagnosis in the early stages because these symptoms don't typically present themselves until the later stages. 

Ovarian Cancer Tests

There are a few ovarian cancer lab tests for cancer monitoring to detect changes in cancer markers.

The CA-125 monitoring test is a blood test that monitors the amount of a certain tumor marker known as CA-125 in the blood. This test has benefits for tracking patients over time who have already had cancer, since your doctor can watch to make sure levels stay low. If levels ever have a sharp increase, the cancer may be back.

The CA-125 test is not as useful for diagnosing ovarian cancer, since a small percentage of healthy women have naturally high levels of this marker. Besides, there may also be instances of ovarian cancer in the body, even when the levels are low.

The OVA1® Test is an aid to help evaluate an ovarian mass for cancer where malignancy is present when the physician's independent clinical and radiological evaluation does not indicate malignancy. OVA1 accurately “detected 94% of cancers in women of all ages” compared with 77% found by using CA 125.

The He4 cancer monitoring test is a newer tumor marker test with the same function as the CA-125 test. This cancer monitoring test looks for a different cancer marker in the blood. This test is still new, so more research may be needed to determine if this test may one day help us diagnose ovarian cancer.

Other tests including an MRI or CAT scan test can help your doctor determine if you have a cyst or tumor in your ovaries or anywhere else in your abdomen. Your doctor may also recommend an ultrasound test, which is quick and can be accurate enough to determine if there are larger tumors or cysts.

These tests cannot determine whether the tumor or cyst is malignant, or cancerous. A biopsy of the tumor in a laboratory can determine if the growth is malignant, borderline, or benign. 

Genetic Testing

Another type of cancer testing preventative test is the BRCA1/2 genetic mutation test. This test looks for mutations in the BRCA1 and BRCA 2 genes, which constitute a higher risk for developing ovarian and breast cancer.

These tests are only recommended for those who may have a genetic predisposition to cancer, and do not tell whether you have active ovarian cancer or a current illness.

Benefits of Getting Tested

The benefits of cancer lab testing are that you can be prepared in the event of a future ovarian cancer diagnosis. Getting a baseline for your CA-125 or He4 levels can help you to stay informed about your body in order for you and your physician to make informed decisions about your health.

There's no need for insurance or doctor's referrals to order your tests online. You can get secure and confidential results online within 24 to 48 hours for most tests. This can help you to keep track of your condition to make sure you're on the path to recovery, and alert you if there are any changes.

Make sure to consult with a doctor or other medical professional if you're unsure about what the results of your tests might mean. It's important to get treatment for cancer from a medical professional.

Take Charge of Your Health

If you or a loved one are in need of ovarian cancer tests for monitoring your condition, you don't have to wait for insurance or a doctor's referral. You can order your tests online with Ulta Lab Tests and take charge of your health today.

Ovarian cancer is a condition that is characterized by the uncontrolled growth of the cells of the ovaries. The ovaries are the reproductive glands that women have on each side of their uterus, located within the lower abdomen. The ovaries serve a couple of functions. They produce progesterone and estrogen, which are the hormones that support the development of a woman’s secondary sex characteristics and that regulate the reproductive cycle. They also develop eggs, which are then released into the Fallopian tube once per month, to travel to the womb in preparation for fertilization.

Ovarian cancer is a common condition and is the fifth most common cause of cancer death in women. The American Cancer Society reports that the lifetime risk of developing ovarian cancer is around 1 in 75. Approximately 22,280 new cases of ovarian cancer are diagnosed every year in the United States, and around 14,240 women each year die from ovarian cancer. Invasive ovarian cancer is a more common cause of death than uterus and cervical cancers, which are more easily detected and more prevalent. Around 20% of ovarian cancers are detected before they have managed to spread from the ovary.

An ovarian tumor can be malignant or benign.  It is not typically possible to tell whether a tumor is benign or cancerous until there has been a biopsy performed. Tests can help to identify which of the three tumor types are present:

  • Epithelial tumors: This is the most common kind of tumor. It begins in the epithelial cells, which are on the outside of the ovary.
  • Germ cell tumors: These are very rare, accounting for fewer than two percent of all ovarian tumors. They occur in the egg-producing cells and are most often found in young women.
  • Stromal tumors:  Just one percent of tumors are this type. They derive from connective tissues in the ovary, which are the tissues that produce estrogen and progesterone.

Benign tumors will not metastasize, but cancerous tumors, if untreated, will spread from the ovary to other areas, including the uterus, rectum, bladder, and lining of the abdomen. Cancerous cells may eventually reach lymph nodes and then spread through the rest of the body.

Calculating the Risk

The key risk factor for ovarian cancer is family history. If anyone in the family (maternal or paternal side) has had ovarian cancer, this can mean that the woman is at a greater risk of developing it herself. The American Cancer Society reports that around five to ten percent of cases of ovarian cancer are thought to be hereditary.

People who have a mutation in the BRCA1 or BRCA2 gene are at greater risk of ovarian cancer. Someone who has BRCA1 mutation is estimated to have a risk of 35% to 70%, while someone with a BRCA2 mutation has a risk of 10 to 30%. If someone has neither of those mutations, then their risk is around 2%.

Women under the age of 40 are less likely to have ovarian cancer. The risk increases with age, and around have of all cases are in women who are 63 years old, or older. Most cases of ovarian cancer develop after menopause. Ovarian cancer is more commonly found in women who are Caucasian than in African American women.

Women who have a personal history of breast cancer are at a greater risk of developing ovarian cancer. The risk is also slightly greater in women who have never had children, those who were obese while young adults, and those who are taking or have taken fertility drugs or hormone replacement therapies.  There is a slightly decreased risk associated with women who have had a tubal ligation. It is thought that low-fat diets, oral contraceptives, and having had children can help to reduce the risk of ovarian cancer.


Ovarian cancers often go undetected because there is no reliable screening method, and the symptoms, especially early ones, are nebulous. For example, symptoms can include:

  • Pelvic pain
  • Chances to urinary urgency or bowel habits
  • Loss of appetite, nausea, and indigestion
  • Bloating, swelling or discomfort in the abdomen


The US Preventative Services Task Force reaffirmed a recommendation against screening for ovarian cancer in asymptomatic women with low-risk factors for ovarian cancer. The reason for this is that there is not currently a reliable method for detecting ovarian cancer in those who are asymptomatic.

Gene tests and multimarker approaches to testing are being evaluated as a way of improving detection rates. The OVA-1 blood test is one test that may be useful. This test measures the levels of five key proteins, to categorize tumors as being high or low risk.

For now, the best approach is thought to be regular physicals, pelvic exams, and having an awareness of family history.

Available Lab Tests

CA-125 is the main lab test that is used to detect and monitor ovarian cancer in women who have symptoms of the condition. Still, it is not recommended for use as a screening method.

HE4 is a new tumor marker that is showing promise, and that can be used to monitor epithelial ovarian cancer in patients that are undergoing treatment.

BRCA-1 and BRCA-2 are genetic tests that can indicate whether a person is at a higher risk of developing ovarian cancer. Still, they cannot be used for diagnosis or to monitor the condition.

Some other tests can be used to monitor or detect ovarian tumors. For example, epithelial tumors can be monitored using tests for carcinoembryonic antigens. However, this test is less sensitive and less specific than CA-125. Germ cell tumors can be tested for using AFPhCG, and LD tests, and stromal tumors can be tested or with Inhibin. None of these tests are sensitive or reliable enough for widespread, routine screening of the population.